“I saw the best minds of my generation destroyed by madness, starving, hysterical, naked….” (Howl: Allen Ginsberg, 1956)
“Hold back the edges of your gowns. Ladies, we are going through hell”.
(William Carlos Williams, poet)
“Time moves in one direction, memory in another”. (William Gibson, science fiction author)
Late one night, and just recently, I was enjoying an internet interview with Sean Stone, son of movie director Oliver Stone, who was recounting events that led up to his first film project. As he explained, during his studies at Princeton he and a group of friends were wondering whether ghosts were real. As one thing led to another, as a kind of midnight prank, they broke into the abandoned relic of New Jersey’s largest psychiatric hospital, known as Greystone Park. As a result of his experiences there and elsewhere, Stone has continued an interest in mystery and the paranormal, which led to the production of his first film: Greystone Park. At the time of his break-in, this facility was in various stages of decay, and dangerous enough with multiple layers of peeling lead paint, asbestos dust, toxic-mold, mildew, creaking stairs; together with dark labyrinths of spider infested underground tunnels. Halls and walls were covered with obscene and satanic graffiti and various passages were littered with mindless detritus left by bored teenagers and other urban explorers. Given this perfect setting for a horror film, it was not all that difficult to imagine or evoke a prevailing mood of sinister presence within that ghastly wreck of a failed institution.
Scarier still, as I watched a bit of shadowy footage from this movie trailer, was a sudden most unwelcome, realization that I had been to Greystone, as a clinical observer during part of a course of study in the early nineteen sixties. Soon after, I also remembered that during the late thirties and early forties, my mother and two of my aunts, who were all nurses, spent three months of their psychiatric training in residence, in those spooky old dormitory buildings adjacent to this hospital. They never spoke about their experiences at Greystone and I never thought to ask.
As I began to research some of the archival materials now available about this forlorn facility, I was also reminded why anyone would prefer to forget their having been associated with that place in any capacity whatsoever.
Looking back on that Greystone experience has now become a difficult process, along with unwelcome flashbacks of those cognitively oriented, (emotionally detached) morning “rounds” with our instructor. Each of our days began with her freshly starched white-coat tour, conducted with some detached and officious academic commentary, along those long hospital corridors, all painted with some vile shade of institutional green; on through to the locked wards. As instructed, we observed a collection of unkempt, confused and neglected patients, isolated in cold rooms with bare mattress and chamber pot, weird sounds and awful smells; rather like a human zoo, incarcerating living representatives of any number of psychiatry’s diagnostic categories. Students also spent time in the less restrictive, pallid, pinkish “common room” populated by heavily drugged, lost looking souls, just standing around, talking to themselves, staring at some wall, or seated in front of a snow-screened TV.
Back on the women’s locked ward, I was assigned a patient to observe as a subject for one of several required clinical reports. I now remember one of “my” patients, a fortyish woman diagnosed with paranoid schizophrenia, who had been in that bare room for years, bars on the window to the outside world and a small square of chicken wire embedded in clear glass in a heavy, perpetually locked door. Since psych students were only there as observers, there was no opportunity to participate in any treatment protocol, and in truth there really wasn’t one prescribed for her.
The name of this tormented soul might have been Margaret. As I read the entirety of her chart, I was astonished to find that there had been no doctor’s notes, for over a decade…only records of medications given. Since there were no professional nurses on this locked ward, medications were distributed by elderly untrained aides who had been there as custodians since, who knows or cares when. I knew her only as a highly agitated figure who spoke only in what is known as “word salads”. Naive as I was then ,I endeavored to listen deeply and find some, any, sense within her ravings. This I was clearly told was futile and I was nearly dropped from the program. These and other experiences within the mainstream medical paradigm soon contributed to my decision to change careers , preferably in some field, as far away as possible, from both medicine and mental health. Graduate study in art and architectural history beckoned as the ideal refuge and the library stacks at UC, Berkeley became my own personal asylum. A glance at my bio reveals how that seemingly well founded decision actually turned out. As some wise sage observed, “sooner or later, you will become what you resist”. (A. St. Just: Relative Balance in an Unstable World, 2006)
Now, as a somewhat elderly cultural historian and social traumatologist, I learn that Greystone was not always such a house of horrors. The institution first opened its doors in 1876 as The New Jersey State Lunatic Asylum in Morris Plains. In those days, in the original sense, asylum meant safe haven, where one could go to be safe from hurting self or others. Later, this word asylum evolved into a negative context as an institution to isolate and contain the insane. (Lawrence A. Osborn, “From Beauty to Despair: The Rise and Fall of The American State Mental Hospital”, psychodyssey.net, July 25,2009). In its day, this facility was designed to become a landmark in progressive mental health care. The idea for such a project was conceived by Dorothea Lynde Dix, a nurse who persistently lobbied for humane conditions for care of the mentally ill based on her conviction that peaceful and aesthetically pleasing surroundings were conducive to healing.
Designed by Pennsylvania Quaker, idealist and proponent of environmental determinism, Dr.Thomas Kirkbride, the facility was constructed by architects Samuel Sloan and Horace Buttolph The interior layout of the structure itself was intended to convey the healing advantages of freshly clean, un-crowded conditions, fresh air and sunlight, in pleasant country surroundings and to physically convey the notion that psychiatric disorders were curable. Set within what was to become a 1,000 acre campus, the main building, now known as the Kirkbride, arose as an immense Second Empire, Victorian Gothic edifice; covered by a magnificent Mansard roof, and (grey stone) granite walls. This monolithic new hospital allegedly formed the largest continuous foundation in the United States, before the erection of the Pentagon on September 11, 1943. Patient amenities included Victorian stuffed furnishings, wool rugs, pianos, pictures, curtains interior plants, and fresh flowers; and a non-denominational chapel with a carefully crafted wood vaulted ceiling, an organ and delicate stained-glass windows. Dining and exercise facilities were available on each patient ward. A spacious floor plan was arranged to accommodate various levels of segregation according to age, gender and severity of illness. Patient population was to be no more than 250 in residence. (Carla Yanni, The Architecture of Madness: Insane Asylums in the United States, 2007)
Over time, this humane reputation was increasingly tarnished as overcrowding was to become the norm. The need was far too great and at one point, the facility, whose name was changed to Greystone Park Psychiatric Hospital in 1924, were housed nearly 10,000 inmates. What followed was an undeniably dark chapter in American and psychiatric medicine. Treatment protocols included various forms of restrain; ice water baths intended to calm (or punish) and hydrotherapy which sprayed alternating hot and cold high-pressure hoses to stimulate depressed, catatonic and otherwise unresponsive patients. Another option was insulin shock-therapy during which suffering individuals were injected with insulin in doses sufficient to place them in daily comas. Electro-convulsive shock-therapy was prescribed for depressive states and a supposed last resort was the frontal, trans-orbital (ice pick) lobotomy for control of impulsive and destructive behavior. All of the above may well qualify for a modern day definition of institutionalized torture.
Lobotomy results, more often than not, produced some measure of de-personalized zombification, listlessness, confusion, disconnection and sometimes these unfortunate recipients were plagued by seizures. A few of these effects of these latter two treatments were dramatized in Ken Kesey’s 1962 novel, One Flew Over The Cuckoo’s Nest, later adapted in 1975 for an academy award winning film starring Jack Nicholson. Kesey described pre-frontal lobotomy as “frontal lobe castration”, a form of societal punishment and control meted out for “troublesome dissidents” after which, “There’s nothing in the face. Just like one of those store dummies … You can see by his eyes how they burned him out, his eyes are all smoked up and grey and deserted inside”. (Grenander, 1978, pp.42-44). In a similar vein, novelist Sylvia Plath’s, The Bell Jar (1963) fearfully described the “perpetual marbleized calm” of a lobotomized young woman.
Originally known as a leucotomy, euphemistically labeled as neurosurgical intervention or psychosurgery,this invasive procedure cut, scraped, and irreversibly decimated connections to and from the pre-frontal cortex, the anterior part of the frontal lobes of the brain. At that time, it was believed that these targeted areas were the locale of “faulty neural pathways”, responsible for promoting excessive emotions. Surgeries were carried out under local anesthesia, which meant that these unfortunate patients were at first subdued with electroshock and later rendered immobile, but not insensate, with curare. This barbaric “treatment”, which was also performed on “difficult children” as young as four years of age, has been controversial since its inception in 1935 by Antonio Egas Moniz; a Portuguese neurologist who was subsequently rewarded with a Nobel Prize in Medicine. Never mind that there was no scientific evidence whatsoever to support any of the breath-taking arrogance of his claims. One can still hope that so many of the subsequent and ongoing tragedies might still serve as a cautionary tale. (Tony Long, “You Should (Not) Have a Lobotomy”,1935, in wired.com, November 2010)
Unfortunately and soon after Moniz’s unfounded claims, pre-frontal lobotomies with various “refinements’ were then in vogue; frequently practiced during the 1940s and 1950s and by 1951 between 40,000 and 50,000 of these “frontal lobe castrations” had been performed in the USA alone. Some were actually, summarily, carried out in private offices and patients sent home in taxis. Other of these so called “surgical cures” involved removal of teeth, tonsils, thyroid and prostate glands. Looking back, it would seem that much of this outrageous quackery was made possible by many of those self-important physicians who felt that almost any intervention was preferable to openly acknowledging their feelings of therapeutic helplessness.(Eliot Valenstein, Great and Desperate Cures: The Rise and Decline of Psychosurgery and Other Radical Treatments, 2010)
Sad as it is, these startling figures of massive frontal lobotomy desecrations also include 2,000 or more of our returning soldiers, neglected by our country’s Veteran’s Administration, most of whom then disappeared into oblivion. While the incidence of these psycho-surgical interventions declined with an introduction of psychotropic medications, trans-orbital lobotomies were performed well into the 1980s; in the US, Great Britain, Scandinavia, as well as a number of Western European countries. These ongoing atrocities were made possible by a lingering belief that lobotomized patients could be safely released from hospitalization or, at least, were rendered sufficiently docile and easier to control. In striking contrast, the former USSR banned this procedure in 1950 on grounds that it was “contrary to the principles of humanity”. (Alan Slomowitz, Ph.D. “Lobotomy: Where Treatment Helps the Doctor, Not the Patient”, Psychology Today, February, 2014).
One of Greystone’s more notable patients was singer, songwriter, political activist and cultural icon, Woody Guthrie (1912-1967) who was in residence there from 1956-1961. The young Bob Dylan made a pilgrimage there to visit his idol and wrote “A Song for Woody”. Joan Baez, The Greenbriar Boys, Phil Ochs and other folksingers came by, and brought along their guitars. Woody was committed after being arrested for vagrancy while wandering aimlessly along a highway with a staggering gait, involuntary gestures and other erratic movements. He was initially diagnosed as paranoid schizophrenic or late stage alcoholic, since his admitting psychiatrist reported that Mr. Guthrie was suffering from “delusions of grandeur”, with claims that he was “a well- known folk singer who had written thousands of songs, now sung by people all over our country”. As family members subsequently confirmed that Woody was exactly who he said he was, his diagnosis was changed. It eventually became clear that his involuntary movements were due to Huntington’s Chorea, a rare hereditary and progressively fatal neurodegenerative disease, also called “the shakes”, about which little was known at that time. There is no known cure. During that era, it was also common practice to commit people suffering from various epileptic and neurological disorders such as Parkinson’s to psychiatric facilities. This policy applied to children, as well, and infants born with Down’s Syndrome, then referred to as “Mongolian Idiots”, and others with developmental disabilities, cerebral palsy, autism or any number and variety of congenital anomalies, were often “sent away” for institutional care.
Artist Phil Buehler recently completed a hauntingly beautiful book entitled Woody Guthrie’s Warty Forty: Greystone Park State Hospital Revisted. Warty Forty was Woody Guthrie’s nickname for his hospital ward at Greystone, which the singer referred to as “Gravestone”. While Buehler seeks to bring to light a forgotten piece of American history, he also invites reflection on how “Gravestone’s” abandonment and decay is connected to how we ignore, isolate or forget the embarrassing, unpleasant or traumatic.
Beat poet Allen Ginsberg was part of Greystone’s cultural history as well. In Howl (1956) one of the most influential poems of the 20th century, which was dedicated to American writer Carl Solomon, he wrote of the “fetid halls of Greystone”. The two met in 1949 in the hospital waiting room when Solomon assumed that Ginsberg was there as a fellow patient. While Ginsberg had spent some months at Colombia Presbyterian Psychiatric Clinic, on this occasion he was visiting his mentally ill mother who suffered from suicidal depression and paranoid delusions, and who had already undergone many hospitalizations involving some 40 insulin shock-treatments. By the time of her death in 1956 she had also undergone electroshock treatments and finally a pre-frontal lobotomy.
In a Dantesque tradition in the poetry of suffering, Howl gives voice to the rage of the outcast, and offers humane sympathy to all tormented beings who inhabit public and private Hells. After his mother’s death, he later wrote the long autobiographical poem “Kaddish for Naomi Ginsberg, 1894-1956”, relating her illness to the Great Depression and other societal struggles. Individual and collective insanity remained themes throughout Ginsberg’s work and he saw within the alienation and suffering of Carl Solomon many reflections of his own, his mother’s and society’s pain. (Jeffery Meyers, “Ginsberg’s Inferno; Dante and Howl”, www. style.niu.edu, 2012)
During Carl Solomon’s encounter with Ginsberg at Greystone, Solomon was seeking voluntary commitment for bouts of depression and hopes of receiving electroshock in homage to his idol, French poet, actor, playwright, and cultural dissident Antonin Artaud; (1896-1948) best known for his Theatre of Cruelty. Solomon believed that Artaud was unjustly imprisoned and institutionalized by the French government for political reasons. Solomon received multiple insulin shock-treatments as he continued to spend time in and out of mental health facilities. While deeply committed to Dada and other Surrealist movements, he eventually wrote Asylum: Afterthoughts of a Shock Patient and other works on a similar theme. Solomon and Ginsberg shared a sentiment along with many others of the Beat Generation that madness was, at least in part, a creative means of protesting the soul deadening pressures of social conformity. (Ronald Collins and David Skover, The Story of Outrageous Lives That Launched a Cultural Revolution, 2013)
Overcrowding at Greystone was somewhat alleviated during the 1970s and 1980s with the advent of Thorazine and a trend toward de-institutionalization in favor of; community based services, group homes, half-way houses and independent living cottages. A decision to finally close the massive facility came in the wake of negative publicity exposing patient abuse, neglect, suicides, escapes of dangerous criminally insane, sexual assaults, and substandard treatment in deplorable, unsanitary, and decaying buildings. At this time, the fate of the once magnificent Kirkbride Main Building was undecided. While the State of New Jersey had it slated for demolition, Morris County citizens groups and the Guthrie family advocated restoration and preservation as a historical monument, open to the public. Given that I am a cultural historian, my bias leans toward preservation, for architectural, as well as local, social and medical history. (preservegreystone.org). Demolishing Greystone’s buildings cannot erase the memory of what transpired within those abandoned walls. Better still, restore the truly historic, palatial, Kirkbride, for many reasons, including a sad testimony to the swift decline of therapeutic optimism into those shadowy, shameful Dark Ages of psychiatry. (Holly Stewart, northjersey.com, April 3, 2014)
Mercifully, at this point in time, great strides have been achieved in psychiatry, patient advocacy, psychotropic medications, behavioral medicine, community awareness and family therapy. Nevertheless, this great social experiment toward de-institutionalization and removing people with acute mental illness from large state institutions has drawn a curious mix of valid optimism, economic expediency and the perhaps the inevitable ideological rigidities. While Greystone’s treatment of the mentally ill, especially schizophrenics, was inhumane, current options are at best, minimal. The proposed money and specialized personnel were never shifted to community facilities; federal guidelines are deliberately vague and oversight is close to non-existent.
A vision of psychiatric treatment and medication as a mechanism of political and social control has understandably infuriated many patients and their advocates here in the United States and other parts of our world; in recognition of psychiatric incarceration and “treatment” as a well-known tool of torture and mind control by totalitarian regimes. Nevertheless, E. Fuller Torrey, critic of social realities surrounding schizophrenia, maintains that “Freedom to be insane is an illusory freedom, a cruel hoax perpetrated on those who cannot think clearly”. In a similar vein, in 1990, Judge Berel Caesar wrote: “The right to no treatment…with the result that we have consigned many persons to lives of quiet desperation and destroyed the mental and emotional health of those who care for them”. Not so surprisingly, we find a vacuum of empathy in the efficiency-oriented bureaucrats who draw up guidelines for so called community-service programs for the mentally ill; when they have never seen a patient, much less treated one. (Andrew Solomon, Far From the Tree, 2012)
I could go on, but it is likely that by now it has become clear that many forms of mental illnessfor patients, their families and other loved ones, as well teachers, employers, neighbors, law enforcement and the rest of us, continue to present a widespread and unresolved social challenge . All too often, our extremely vulnerable, mentally ill citizens, without financial or community resources or who are for whatever reason, “off their meds” are finally relegated to some street, under a bridge, back alley, tube station, homeless shelter or more likely prison. Even worse, all too many are rounded up, brutally confronted, sexually exploited, repeatedly tasered, savagely beaten or even shot by our increasingly militarized police. One then wonders how far have we really come as a supposedly sane society, in relation to the care and responsibility for those we designate as insane. Surely, here and now in this supposedly enlightened 21st century, we can do better.