In December 1945, Ezra Pound was committed to St. Elizabeths Hospital in Washington, DC. He was then 60 years old, internationally famous, and under indictment for treason against the United States. In an infamous series of broadcasts made on Italian radio between 1941 and 1943, Pound had declared his support for Mussolini’s regime and his contempt for the Allied forces. He parroted fascist talking points but also added a layer of byzantine anti-Semitic conspiracy theory all his own. “You let in the Jew and the Jew rotted your empire, and you yourselves out-Jewed the Jew,” he admonished the British on March 15, 1942. In other broadcasts, Pound spoke of “Jew slime,” warned of the white race “going toward total extinction,” suggested hanging President Roosevelt (“if you can do it by due legal process”), praised Hitler’s Mein Kampf, and urged his listeners to familiarize themselves with The Protocols of the Elders of Zion.

Pound had arrived at this vicious ideological position gradually. His early work, while always concerned with the relations between art and society, had rarely been political per se. Over the years, though, his long poem The Cantos, started in 1915, had drifted from a preoccupation with mythological subjects to an investigation of economics and governance, influenced by heterodox economists like C.H. Douglas and Silvio Gesell. By the time the Second World War began, Pound had come to blame the practice of usury, propagated by a secret network of nefarious Jewish bankers, for all the evils afflicting the world.

After relocating to Italy in 1924, Pound became an ardent supporter of Mussolini, who he believed shared his economic views. He collaborated with the regime right up until the fall of the Nazi-backed Republic of Salò in April 1945, when he turned himself in to American military officials, and spent months in a detention center in Pisa before being extradited to the United States and eventually institutionalized at St. Elizabeths, the nation’s oldest federally funded mental hospital.

At first, access to Pound was sharply restricted. For 13 months, he was held at Howard Hall, the hospital’s maximum-security ward for the violent and criminally insane, an area enclosed by a 22-foot concrete perimeter wall. Over time, however, these restrictions were loosened. In early 1947, Pound was moved to Center Building, a less fortified area, and granted more leeway in receiving visitors. He had been, by this point, a driving force in modernist cultural circles for over three decades, and many American writers he had helped or influenced were eager to visit him.

Some of the guests were old friends from the heyday of high modernism, like T.S. Eliot (with whom he played tennis), Marianne Moore, and William Carlos Williams. But he also attracted a legion of younger poets eager to pay their respects, including Charles Olson, Robert Lowell, John Berryman, Louis Zukofsky, Elizabeth Bishop, W.S. Merwin, and Frederick Seidel. Eventually, Pound was granted permission to spend his days out on the lawn, lecturing to a group of eager young disciples who dubbed themselves “Ezrologists.” “It was the world’s least orthodox literary salon,” Daniel Swift writes in his elegant and provocative new book, The Bughouse: The Poetry, Politics, and Madness of Ezra Pound, “convened by a fascist, held in a lunatic asylum.”

Most of the writers who visited Pound at St. Elizabeths wrote about it, and a good portion of Swift’s book is given over to analysis of a curious literary subgenre he calls “the Tale of the Bughouse Visit.” (“The Bughouse” was Pound’s own preferred term for his environs.) The most famous instance is probably Bishop’s poem “Visits to St Elizabeths,” which borrows the iterative structure of the nursery rhyme “The House That Jack Built” to describe a man portrayed variously as “tragic,” “talkative,” “honored,” “brave,” “cranky,” “cruel,” “busy,” “tedious,” and “wretched.” But the hospital also finds its way into Williams’s Paterson, Olson’s The Maximus Poems, Berryman’s Dream Songs, Lowell’s sonnet “Ezra Pound,” and Seidel’s “Glory,” not to mention assorted autobiographies, memoirs, diaries, and other prose accounts.

It wasn’t only literary types who frequented or wrote about St. Elizabeths, however. Even as his writer friends were celebrating his literary accomplishments, Pound was attracting new adherents from the American far right. One of the most devoted of the Ezrologists was a young man named Eustace Mullins, an anti-Semite and conspiracy theorist who later became a prominent Holocaust denier. At Pound’s instigation, Mullins began work on a book called A Study of the Federal Reserve, which, according to Swift, “recounts the dastardly founding of the Fed in a plot against the spirit of Jefferson and the principles of American democracy…backed by the Rothschilds.”

Another protégé was John Kasper, the owner of a bookstore in Greenwich Village specializing in racist and anti-Semitic literature. (He’d named it Make It New, after one of Pound’s most famous critical pronouncements.) Later, Kasper became a leading figure in the right-wing reaction to the Supreme Court’s Brown v. Board of Education decision. In 1956, he founded the Seaboard White Citizens Council and issued propaganda that reads like a bad parody of Pound’s own fulminations:

Now damn all race-mixers
The stink: Roose, Harry and Ike
God bless Jeff
Jax and John Adams
Also Abe
Loathe carpet-bag
Despise scalawag
Hate mongrelizer

In 1957, Kasper was arrested for inciting a riot against the desegregation of Nashville schools. The New York Herald Tribune reported on Kasper’s connection to Pound, and his friends Archibald MacLeish and Ernest Hemingway worried the link would further damage Pound’s reputation. But “Pound welcomed Kasper in and never denied his association,” Swift writes. “He stayed loyal to that which damaged him.” In fact, at the same time, Pound himself was publishing pseudonymous journalism on similar themes. “It is perfectly well known that the fuss about ‘de-segregation’ in the United States has been started by Jews,” he wrote in August 1956.

The period of Pound’s institutionalization at St. Elizabeths also marked the beginning of the rehabilitation of his literary reputation. Friends and admirers like Eliot and James Laughlin, Pound’s publisher, couldn’t deny his commitments to fascism and anti-Semitism, so they sought to downplay them by shifting attention to his poetic innovations. This project was aided by the rise of the New Criticism in American universities, which insisted on the excision of biographical, historical, and ideological concerns from the evaluation and interpretation of literature.

This campaign worked well enough in literary circles, but it was less effective with the general public and the legal establishment, both of which were keen to hold Pound accountable for his wartime activities. Here, another strategy was necessary. Pound had clearly forfeited the role he’d long cultivated, as the visionary leader of a political and cultural vanguard. But perhaps he could be presented as another, equally familiar archetype: the brilliant poet touched by madness.

Was Pound really mentally ill? Or had he been faking it all along? In his influential The Roots of Treason: Ezra Pound and the Secret of St. Elizabeths (1984), the psychiatrist E. Fuller Torrey claimed that Pound’s lawyer, Julien Cornell, in cahoots with Dr. Winfred Overholser, the superintendent of St. Elizabeths, conspired to present an eccentric and egocentric but essentially sane individual as a madman in order to preserve his reputation and, possibly, save his life.

It’s true that, if convicted, Pound could well have faced the death penalty: A number of fascist and Nazi collaborators, including Britain’s William Joyce, Norway’s Vidkun Quisling, and France’s Pierre Laval, were executed for treason by their home countries. Cornell decided early on that having his client declared mentally unfit to stand trial was the wisest course. The gambit worked: The jury at Pound’s sanity hearing took only four minutes to decide that the poet was “of unsound mind.”

The price of Pound’s survival, as Swift sees it, was a public renunciation of his authority as a writer and thinker. Having spent decades setting himself up as an expert not only in literature but in politics, economics, history, anthropology, and Sinology, among other fields, Pound was now admitting that he lacked the mental competence to stand trial. The Cantos was meant to be “a poem containing history” that synthesized all Pound knew and believed into an epic masterpiece that would help put civilization on the right track in the 20th century. Now it was used as an exhibit demonstrating its author’s incoherence.

Before Pound’s sanity hearing, Cornell presented extracts from The Cantos that the poet had composed during his incarceration in Pisa to four expert psychiatrists as “evidence of his mental condition.” On the stand, one of them, Dr. Wendell Muncie, testified that, on the evidence of this and Pound’s other writings, he judged that “there has been for a number of years a deterioration of the mental processes.” Here was Pound’s own putative masterpiece held up as proof of his disintegration.

Though Swift doesn’t mention it in The Bughouse, some major paradigm shifts within the American political and medical communities helped to establish the conditions under which the Pound defense was possible. In their recent study Are Racists Crazy?, Sander L. Gilman and James M. Thomas show how, during the early decades of the 20th century, racism and anti-Semitism began to be regarded more and more as pathological conditions. While psychology had earlier focused on the supposed irrationality and moral degeneracy of nonwhite races, utilizing theories that often harmonized with Pound’s own, the discipline gradually shifted, especially as details of the Nazi Holocaust began to emerge, and came to see racism as itself a psychological problem. The theories of émigré psychoanalysts like Erich Fromm, Erik H. Erikson, and Wilhelm Reich, who regarded racism, fascism, and anti-Semitism as symptoms of arrested development or sexual repression, only helped to confirm this notion. “[I]f the nineteenth-century Jew and black American bore the mark of insanity,” Gilman and Thomas write, “by the end of World War II that mark would be placed upon those whose hatred targeted the Jew and black American.”

Over the course of The Cantos’ decades-long composition, then, Pound’s prejudices went from being considered acceptable, if not exactly commonplace, by cosmopolitan elites to being considered morally odious, if not insane. (One need only compare the way anti-Semitic references disappear from the later poetry of Pound’s friend and protégé Eliot to see an index of this change.) In a strange way, Pound benefited from this midcentury lurch in elite public opinion away from racism and anti-Semitism: It was now much easier to cite his fervent espousal of such ideas as evidence of mental illness. Anyone as passionately and consistently full of hatred as Pound, the argument went, must be insane.

The insanity defense may have saved Pound’s life, but it has created permanent difficulties for assessing his literary achievement and, for that matter, reckoning with his politics. The simplest courses are to denounce Pound’s work in total (easy enough to do, particularly for critics who were already hostile or indifferent to modernism) or to bracket its ideological content, suspending judgment and even, in many cases, understanding. (This, too, can be seen as a by-product of Cornell’s insanity defense: If Pound’s racism is merely a symptom of his madness, why bother to track its logic or try to comprehend its appeal?)

While a great deal of excellent scholarship has been published on Pound’s fascism, there is still a tendency among those who study him to minimize or ignore his politics. Of his visit to the 2013 Ezra Pound International Conference (EPIC) in Dublin, Swift reports: “I hear ‘versifier’ used as a term of abuse, and an hour-long elucidation of three lines of a fragment. I hear an awful lot of gossip about long-dead literary editors. I hear no mention of fascism or anti-Semitism.”

Swift is a Poundian: He is clearly someone who admires Pound’s work and finds it worth grappling with, in spite of its political and moral ugliness. The Bughouse is not only a work of historical research and criticism; it has something of the character of a personal homage. Swift’s own visits to St. Elizabeths and other significant locales in Pound’s life are described in such detail that they seem like pilgrimages as much as research trips, and he allows himself to follow tangents (about Pound’s fashion sense, his love of tennis, his ancestor’s interest in wireless telegraphy) that attest more to Swift’s immersion in Poundian ephemera than anything else. The book is also full of sensitive, generous readings of Pound’s poetry, from the early lyrics collected in Personae to thornier passages from the late Cantos. Swift is particularly good on Pound’s “Elizabethan” writings: the works actually composed at St. Elizabeths, including the cantos eventually published in 1955 as Section: Rock-Drill and the translations of Sophocles’ tragedies and the odes of Confucius, which, Swift nicely demonstrates, “encode the sensations of the hospital” and catalog its flora and fauna.

But Swift, to his credit, doesn’t shy away from the aspects of Pound that are infuriating, disturbing, or unacceptable. Virtually everyone is prepared to admit that Pound was a fascist, a racist, and an anti-Semite; what’s harder to accept is that his political views are not incidental but central to the poetic project that constituted his life’s work. “The grand bad faith of the Cantos—its pomposity, its anger—is a constant, running line after line,” Swift notes. He also recognizes that there is something more at stake here than just literary reputation. Pound is not the only major 20th-century literary figure who supported fascism or held racist views; but he is the only one who engaged with the extreme right of the postwar era, and today his particular blend of economic populism, conspiracy thinking, and overt racism, far from seeming eccentric and anachronistic, is disturbingly contemporary. We hardly need reminding, in these days of resurgent white nationalism, that many of the noxious ideas Pound advocated are far from extinct.

At one point, Swift travels to Rome to talk with members of CasaPound, an Italian neofascist organization that draws inspiration from Pound’s work and makes use of his name and image in its propaganda. “They call themselves ‘I ragazzi di Ezra’—Ezra’s boys,” he reports. While Pound’s influence is less visible on the American alt-right scene, it isn’t difficult to trace the lines of intellectual genealogy, via the likes of Eustace Mullins and John Kasper, to the present-day demagogues who headlined the “Unite the Right” rally in Charlottesville, such as Richard Spencer, Christopher Cantwell, and Augustus Sol Invictus. (Invictus, in particular, seems to be a Pound aficionado: He has called him “my American fellow fascist” and uploaded his own recitations of Pound’s poetry to YouTube.) If Pound were alive and writing today, who knows what company he’d keep?

Pound was released from St. Elizabeths in May 1958, 13 years after he went in. There are at least two ways to tell this story. The more famous one is that Pound’s release constituted a kind of unofficial pardon: It was the result of a long campaign on his behalf by luminaries like Robert Frost, Frank Lloyd Wright, Igor Stravinsky, and Hemingway. (After he won the Nobel Prize in Literature in 1954, Hemingway was quoted as saying, “This would be a good year to release poets.”) This explanation is the obvious one from the point of view of literary history: The significance of modernism was, by the late 1950s, practically dogma among US elites, and Pound, whatever his sins, was unquestionably one of its leading figures. (It probably helped that elite attention, in the era of Cold War liberalism, was obsessively focused on the left and on the threat posed by Soviet Communism; in such an atmosphere, the persistence of Pound’s links to the right-wing fringe were likely well down the list of priorities.)

Swift, though, provides a counternarrative that is, in its way, equally convincing. Pound’s 13-year institutionalization, he points out, coincided with an epochal shift in the treatment of mental illness in the United States. St. Elizabeths, the first federally operated mental hospital in the country, had been constructed in the 1850s as part of a movement to provide “moral treatment” to the insane, an improvement upon the hellish asylum conditions common in the first half of the 19th century and earlier. The hospital’s “design casts in bricks and wood a theory of care,” Swift writes. “The grounds were therapy.” But by the time Pound was discharged, in the late 1950s, Overholser was declaring psychiatry to be on “the verge of a new era in the treatment of mental disorder…a pharmacological era.” The prescription of psychotropic drugs like chlorpromazine and reserpine was becoming more routine; by 1957, close to half of the patients at St. Elizabeths were taking them. The medical paradigm was shifting away from institutionalization and toward medication. Americans were becoming more willing to accept that the mentally ill, properly tranquilized, could be integrated into society.

In this interpretation, Pound was less a special case singled out for his cultural significance than just one of the many patients affected by what historians of psychiatry call “deinstitutionalization.” “Where once [St. Elizabeths] had been a castle, fortified and apart, now in an era of pharmacological cures and community treatment, its walls were dissolving,” Swift writes. When Pound announced, upon his return to Italy, that “all America is an insane asylum,” this is probably not what he meant.

There is still a fundamental inconsistency, Swift suggests, in how we view Pound. He ended up in St. Elizabeths because his friends were able to convince a jury that a poet of such sensibility and intelligence who said the things he said and wrote the things he wrote must be crazy. But to adopt this same attitude to Pound’s legacy—as Swift convinces us we largely have—is both to let him off the hook morally and to limit our engagement with his writing to a sterile formalism.

The Bughouse doesn’t provide a solution to this dilemma; it doesn’t even offer a new way of seeing Pound. But it does insist on contradictions in our common response to ideas like his that no scholar of modernism, and no citizen of the United States, can currently afford to overlook. It is, after all, no longer impossible to imagine a country where an Ezra Pound, after years in the wilderness, might suddenly appear reasonable, and where we—the believers in tolerance, equality, and democracy, or so we like to think—are the ones who belong in the bughouse.