The Lives They Left Behind is an intriguing historical tale about the Willard Psychiatric Center, located in Seneca Lake, New York. Although it operated for 126 years with over 54,000 people calling it “home” during those long years, the book focuses on the time period between 1900 and 1960 — some might argue the “dark ages” of inpatient psychiatric care.
The Lives They Left Behind is the story behind 427 suitcases discovered in the attic in 1995 in of the one of the buildings at Willard Psychiatric Center, after the state had decided to leave the entire facility. Recognizing the historical treasure-trove, Craig Williams ensured that the suitcases were packed up and taken away for later review and cataloging by archivists and curators in 1998.
If all of this sounds vaguely familiar, it should. The three people who eventually worked on the project — Darby Penney, Peter Stastny and Lisa Rinzler — collaborated and turned it into a major exhibit at the New York State Museum in 2008 and a thoughtful, informative website which we wrote about last year. The book is the weaving together of a history of Willard Psychiatric Center as typical of the large, government-run inpatient psychiatric hospitals popular throughout much of the 20th century along with the histories of a few of the patients, pieced together through historical patient records, documentation, and even remnants gleaned from the suitcases themselves.
Although some lament that the story told by the authors is one-sided, I expected that going into the book. And despite that expectation, I didn’t find it nearly as one-sided as some other reviewers have claimed. The 1900s through the 1950s were horrible times to be hospitalized with a mental illness. Procedures routinely performed during this time include heavy sedation and electrical shock as a means to help people overcome their mental afflictions. Patients were classified not according to their diagnosis so much as their willingness to go along with whatever the staff asked of them (or in some cases, demanded). Failure to comply could mean isolation and physical abuse.
So many excerpts are interesting, including the unintentionally funny interviews that passed as a clinical interview:
Doctor: Did you have a lot of seizures while you were there?
Patient: Three or four attacks.
Doctor: What did you do?
Doctor: Make a lot of money?
Patient: $30.00 a day sometimes. [This was in 1930]
Doctor: Who did you work for?
Patient: Dr. Munson. […]
Doctor: You know what kind of hospital this is, don’t you?
Doctor: Are you insane?
Patient: That is up to you.
Doctor: What do you think about it?
Patient: I don’t know anything about it. There are violent people here.
Doctor: Why do you think they sent you here?
Patient: I don’t know.
Doctor: Do you think you are crazy?
Doctor: Did you complain that the food was poison?
Patient: Not that I know of.
Doctor: Think anyone was plotting against you?
Patient: No. A fellow having a couple of spells would go this way. […]
It goes on, but basically here was a guy who learned photography, was making a pretty good living by 1930’s standards, and from the interview excerpted in the book, showed little signs of having any type of mental illness or distress. Nonetheless, he then spent the next 35 years hospitalized at Willard. He brought a camera to Willard, but was never allowed to use it, nor given any hope of ever again entering the outside world.
Such conditions helped create thousands of docile zombies who indeed no longer much cared about their depression, neurosis or psychosis (if they actually even had a mental illness in the first place), as they had few coherent thoughts left after the so-called treatments and their lack of care by the staff who were responsible for their well-being. People lived out their entire lives in these facilities doing little other than simply existing. It is a horrible, isolating solitude that is simply unimaginable in our always-on, connected 24/7 world today.
This book should be a “must-read” for any student of psychology or psychiatry considering going into the profession as a clinician or physicians. Positions of trust and power are easy to abuse once a person has given their entire lives over to a professional, and routinely abused they were. The stories told by the authors in The Lives They Left Behind are the same stories you could hear from hundreds of thousands of families who lost a family member to these institutions. And I say “lost” because one study the authors quote noted that up to 58 percent of those admitted never left the facility or died while under its care. Chances are that if you entered one of these hospitals, you may never have gotten out.
A short epilogue notes that despite the many advances made in psychiatric treatments since the 1970s, we still have many holes in the mental health care system in America. I can’t disagree with that observation. We’ve closed most of these state psychiatric hospitals in the U.S., but many of the same people have simply moved into other facilities, like prisons and, as they age, nursing homes. It’s well known that most people with mental illness living in nursing homes (300,000) and prisons (1.25 million) get substandard care (if any at all outside of a psychiatric prescription).
427 suitcases were left behind by 427 patients, lost to time. But some of their stories were not lost, and are retold with care, compassion and insight in this book. If you’re interested in such personal stories interwoven with the history of mental illness in America, this is a book well worth the read.
Softcover, 205 pages.