New York State Asylum for the Insane, Utica, from http://nysasylum.com/utica/images/7655.jpg
Having learned what diagnoses might lead to committal to an insane asylum in the nineteenth century, I set about creating and populating the hospital in SEEING THE ELEPHANT.
Dr. Stanley is a humane man who has embraced the Moral Treatment Method, which was designed by Dr. Aramiah Brigham, the first superintendent of the New York State Asylum for the Insane in Utica.
You may find Brigham’s detailed plan in an article he wrote and published in “The Journal of Insanity.
According to the current-day introduction to the above article: “Brigham presents asylum life in domestic terms; the asylum becomes an ideal middle-class home in which people are nurtured back to mental health and where coercion, if not eliminated, is minimized. Note the unusual role played here by at least some of the attendants. He envisioned them as fulfilling a task that would later be done by psychotherapists. Brigham emphasized “rational” amusements as part of treatment.”
At the beginning of his article Brigham provided a brief outlined the moral treatment method:
The removal of the insane from home and former associations, with respectful and kind treatment under all circumstances, and in most cases manual labor, attendance on religious worship on Sunday, the establishment of regular habits and of self-control, diversion of the mind from morbid trains of thought, are now generally considered as essential in the Moral Treatment of the Insane.
(A source where you may find Brigham’s article is cited at the end of this post.)
The Western New Jersey Hospital for the Insane, therefore, would have rooms to accommodate activities such as plays, lectures and dramatic readings, a newspaper or magazine print shop, and rooms for art and other activities. It also would have a farm that would produce food for the hospital, but the farm and flower gardens also would provide prescribed manual labor therapy for patients.
Early on in SEEING THE ELEPHANT Eli and Frankie, with Rev. George Lowry, visit the hospital. Here is what they see upon arriving
There was no sign of human habitation until the trees abruptly parted to reveal a wide lawn punctuated by trees, shrubbery, and gardens.
“This must be beautiful when spring comes,” Frankie breathed.
“It is,” George assured them, “People from all over come here to picnic.”
“Picnicking outside a madhouse,” Eli mused. “What a notion! And I thought picnicking in rural cemeteries was macabre.”
At the far end of the lawn lay an imposing building constructed of gray stone and mortar. The eye was immediately drawn to its three-story central section. Its portico was guarded by graceful Grecian columns and a roof. The message in the architecture was clear: visitors, doctors, attendants, and inmates alike were entering a place of importance, a place of healing, perhaps even a place of holiness. To either side of the main building were wings, also three stories in height.
Impressed, Eli let loose with a whistle.
“That center section contains the doctor’s office, a print shop, an auditorium, an art studio, six dining rooms, and several lecture rooms,” George was saying. He pointed to the wings. “Those are where the patients are housed. The wing on the left is for the men, the one on the right for women.”
The hospital in the novel has three main wards: convalescent, for those who are getting well enough to return home; general for those who need prolonged treatment; and violent for patients who cannot mingle safely with others and are kept in cells.
I then had to people the hospital with patients. It’s not a very big institution, but Dr. Stanley has plans to expand as experience, time, and money permits. Using the lists of diagnoses found during research, I assigned one to each hospitalized character, whether we got to know them well or not. The reason for this was I needed to know what people were “in for” to understand what the emotional balance in the hospital would be like as I designed the plot. The patients’ list of reasons for admittance is listed below, followed by any background I had developed.
Convalescent Ward (female)
“Excessive Fear” (husband is a captain in the Army)
“The War” (t has a beau in the cavalry)
“Grief (three sons died in the war)
“Politics” (husband admitted woman for having political opinions)
General Ward (female)
“Religious Excitement” (had too much interest in religion)
“Seduction and Disappointment” (tried to run off, was intercepted, and returned home)
“Desertion by Husband”
Violent Ward (female)
“Hereditary Periodical Fits” (also seems disconnected with reality)
Convalescent Ward (male)
“Exposure” (fought in the war, panic attacks)
“Melancholy” (fought in the war)
“Intemperance” (“That means I was a drunk. Got myself corned on a regular basis…”)
General Ward (male)
“Indigent and Aged” (old and no one wanted him)
“Gunshot Wound and Grief” (fought in the war)
“Soldier’s Heart” (fought in the war)
Violent Ward (male)
“Murder, Assault, Outbursts”
We get to know the people in the Convalescent Wards best, since Frankie works as an attendant in the women’s Convalescent Ward and Eli is living in a cottage on the grounds as he researches he hospital for an article… and secretly receiving treatment for his nightmares and panic attacks. We do get to see some of the other patients toward the end of the novel when, to put it bluntly, all hell breaks loose.
Hope you enjoyed our little journey into the world of “madness,” hospitals, and SEEING THE ELEPHANT.
July, A.B. (1847, March). The moral treatment of the insane. American Journal of Insanity. Retrieved [3 September 2015] from http://www.socialwelfarehistory.com/?p=10442.