The Philadelphia State Hospital at Byberry: A History of Misery and Medicine (Landmarks) (PA)

by J. P. Webster

  Examining brain tissue in N-3 laboratory, circa 1952. Pennsylvania State Archives, RG-23.

  The new warehouse completed the utility group in 1954. With 250,000 cubic feet of space, it was large enough to accommodate the supplies that a hospital of six thousand patients required. Its refrigerated storage area contained 100,000 cubic feet and could hold a massive food supply. A new stretch of the power plant’s railroad siding connected the warehouse to the New York Short Line, and its intercom system was very futuristic at the time. The Ergo-Therapy department placed patients into jobs of all sorts around the institution, and the utility buildings employed almost five hundred.

  Groundbreaking for N-3. Left to right: Frank W. Mark (construction firm), George W. Pepper Jr. (architect), Furey Ellis and Dr. Eugene Sielke, 1947. Temple University Urban Archives.

  In June 1954, Dr. Sielke announced the interior remodeling of four buildings on the East Group, beginning with E-2 and E-4 (buildings A and F). Sielke explained that “the old buildings consist of one main floor and a second-story rise in the middle of each, consisting of a few rooms. They were constructed as one large dormitory and day room.” He described the plans to cut up the large wings of the buildings, adding partitions and creating separate rooms. “We have found this arrangement better in caring for our patients,” he said. “The large, armory-type atmosphere of the old buildings had a depressing effect on patients.” The work was completed in a year, and two more buildings on the East Group were remodeled.

  On the night of November 4, 1954, Coroner Joseph Ominsky received his fifth elderly male patient from Byberry in six months. He claimed the autopsy of Max Kramon revealed internal brain hemorrhaging, but the cause of death was listed as “coronary thrombosis.” Kramon, seventy-three, was found on the floor with a swollen lip; a bruised eye, nose and forehead; and cuts on his scalp. In seemed like strange deja vu at the coroner’s office, and another investigation began into Byberry. “There are at least four other deaths at the hospital, which have not been explained to our satisfaction,” blasted Ominsky, “and we want to know what actually happened.” The hospital’s response was that Kramon actually fell, causing his death. It was learned that the men were housed in building B because they had exhibited violent behavior. Dr. Sielke organized a regrouping of patients, and the elderly were no longer placed in the violent ward.

  After being told to “hold on” several times and patiently doing so, advocates for better religious services for patients were finally satisfied when bids were accepted for a new chapel and auditorium building. In 1955, the GSA approved $684,746 for the building, which included a pipe organ, a chapel, two full-sized thirty-five-millimeter projectors for movies and a seating capacity of 1,200. But by the time it opened in 1957, the cost had increased to over $1 million. The GSA, along with members of Department of Welfare and hospital staff, decided to name the building after Furey Ellis, for his eleven years of “devoted service” as board chairman. The building’s architects, Nolen and Swinburne, placed a plaque of Ellis in the ultra-modern lobby. At the building’s dedication in May 1957, Ellis was eulogized by a host of characters, including new Welfare Secretary Harry Shapiro, Dr. Earl Bond and Dr. Sielke. He was presented with floral arrangements and cards. The building was connected to the West Group via an extension of the north connecting hall.

  Governor James Duff sets cornerstone of N-3, 1950. Pennsylvania State Archives, RG-23.

  Religious services improved further at Byberry when it was decided to use one of the empty cottages off the children’s group (PIFM) as a chapel for patients. The location would provide a quiet environment at a distance from other buildings. In June 1960, the Society of St. Vincent de Paul donated a life-sized statue of Christ, which was placed in a shrine outside the cottage. In December 1961, hospital Rabbi Abraham Novitsky and trustee Samuel M. Feldman enlisted the help of local businessmen, congregations and private donations from the Jewish community to rehabilitate another of the unused cottages into a synagogue for the hospital’s seven hundred Jewish patients. The new synagogue in cottage 3 was dedicated on December 7, 1961. It was the first facility for Jewish patients at any state hospital in Pennsylvania.

  Other faiths soon followed and redeveloped the remaining cottages into chapels. One became a Protestant chapel, and two others were converted into Catholic chapels, one for male and one for female patients. In 1965, the last remaining cottage was converted into a new Catholic chapel named for the patron saint of the mentally ill, St. Dymphna. Its first full-time chaplain, Reverend Richard J. Fleming, said that the addition of the chapel, completing the chapel group, provided Byberry with one of the largest and most complete religious programs of any hospital in the state.

  By 1962, Byberry’s problems had begun to float up to the surface. The hospital contained 6,300 patients, about 400 of whom were court-ordered, or forensic patients. Since Byberry contained two “maximum security” buildings, the state used them to house dangerous criminals (often murderers), as they had for decades in building B. The difference now was made by new human rights laws, which called, ironically, for proper treatment of prison inmates. Once tried for murder, if found guilty by reason of insanity—no matter how heinous the crime—the law required that an inmate serve his sentence at a hospital, not a prison. Byberry being the only forensic hospital in southeastern Pennsylvania, it naturally bore more of a load than was technically required.

  Autopsy theater in N-3, 1950. Pennsylvania State Archives, RG-23.

  The maximum-security buildings, or buildings for “over-active patients,” were N-8 and N-9. Built solidly under the auspices of top mental health officials a little over a decade before, these buildings were plainly showing that they were not very “maximum” at all. The windows were protected by thick screens that were meant to prevent escapes, but in the span of two weeks in April 1962, at least eleven patients escaped through the screens. Commenting on the escapes, Dr. Sielke said, “Until recently, we haven’t had to cope much with this type of case. The average mental patient is pretty much individualistic. He doesn’t plan for a group. If he escapes, he does so by himself. But the psychopaths, some of them, are very intelligent. They plan well. When they escape they take a whole bunch of fellows. It’s almost like a prison break.” Sielke asked for the construction of a new “escape-proof” building, or the renovation of an existing building, for this type of case. He stressed that unless the law was changed, Byberry would need financial help to improve the situation. “We are trying to combine a prison and hospital, and these are incompatible,” he said. “We oughtn’t to be in this predicament. From the standpoint of a hospital, these patients are difficult. They don’t respond to tranquilizer or psychotherapy. They are intelligent and clever and can lead other patients astray. We are not physically equipped to control them.” The GSA acknowledged the dilemma, but nothing would be done until the placement of the forensic unit twenty-three years later. The slope that Byberry teetered on the edge of was a steep one. When it fell, it would take a long time to hit the bottom.

  Construction of N-10, showing foundation of basement recreation area, 1950. Pennsylvania State Archives, RG-23.

  Chapter 6

  THE NEW APPROACH

  Deinstitutionalization at Byberry

  By 1963, President John F. Kennedy had succeeded in pressing for public awareness of the flaws in the American mental healthcare system, allegedly due to the commitment and lobotomization of his sister and the painful effects on the family as a result. Congress passed the Community Mental Health Centers Act, allowing each state to build many small health centers for the treatment of a smaller number of patients, as opposed to treating a larger number in fewer, much larger facilities like Byberry. It also called for separate centers for the mentally retarded, who until now had been housed in state hospitals among insane patients. Byberry became showcased nationwide as an example of this policy. How Philadelphia would deal with its longtime public health disaster piqued everyone’s curiosity, but until the lat
e 1960s, it was just talk. While Kennedy’s concept of “de-institutionalization” gradually began emptying America’s mental hospitals, its effects were different in every state. Pennsylvania proved to be a state in which deinstitutionalization was not overwhelmingly popular. A year later, the Pennsylvania legislature passed the Mental Health/Mental Retardation Act, which set up each county, broken down into districts, with a number of community health centers based on population. In Philadelphia, the city as a county, was divided into thirteen BSUs (Base Service Units). It was naturally the most populous county in the state and proved to be the most difficult to manage.

  Laundry building, 1954. Pennsylvania State Archives, RG-23.

  Pressing floor of laundry building. Pennsylvania State Archives, RG-23.

  Dedication of N-10 building, 1952. Pennsylvania State Archives, RG-23.

  Dr. Frank Hasselbacher, state director of mental health, arrived at Byberry for a surprise tour in February 1965, accompanied by Inquirer staff writer Ralph K. Bennett. The two men were greeted by Dr. Sielke, who had no problem showing the men around the institution. In the East Group, Sielke noted building A’s transformation and contrasted it to building D, which had not been renovated. When touring the north group, Sielke explained the abundance of geriatric patients. “There are about three hundred mental patients here who really don’t have mental disorders, who could be taken care of in any nursing home,” Sielke said. “But they are old, some of their families don’t want them or they can’t keep up payments on a private nursing home, so this is the place of last resort. We can’t turn them away.”

  An elderly man approached the men, apparently having overheard them. “I’ve been here thirty-two years,” he said. “I was kidnapped, and I’ve been here thirty-two years.” The tour moved on to the women’s geriatric ward, where the men were approached by another patient. An elderly woman, sobbing, walked up to the men. “Thank the good lord you’ve come,” she gasped. “I want to go home to my mother.” Sielke informed Hasselbacher that the woman was seventy-seven years old and probably was suffering from dementia. “Good care is all we can give many of them,” said Hasselbacher. “But good care is not bars or walls, its supervision—people.”

  In November 1965, Dr. Sielke, with as little publicity as possible, submitted his resignation after almost twenty-five years at the hospital, nineteen of which he served as the superintendent. State mental health commissioner Dr. William Camp reported Sielke’s decision to newspapers. “He had deep feelings for the hospital,” Camp said. “He told me he was tired and felt it was time he gave it up. He didn’t want a lot of fanfare.” Sielke was known throughout the community as a caring doctor who never gave up on Byberry. His years at the hospital were testament to his dedication.

  Upon his retirement, however, State Auditor General Grace Sloan attacked the condition of the hospital and Sielke himself. Sloan claimed that Sielke used the hospital’s security detail as personal servants. “The security force is, to some degree, not more than a delivery service for certain hospital officials,” she said. Sloan charged that in the first two weeks of September, “there were 20 entries indicating that a security guard delivered butchered bones to Dr. Sielke’s residence for his dog.” The level of escapes had increased, she said, because of Sielke’s “misuse” of hospital personnel. “From January 1st to August 22nd, 1965, records of the hospital indicate there were a total of 337 patient escapes,” Sloan said.

  New Furey Ellis Auditorium, 1958. Pennsylvania State Archives, RG-23.

  Bus in front of cottage chapel, circa 1965. Pennsylvania State Archives, RG-23.

  View showing connecting corridor. N-8 (left), N-9 (right) and N-10 (rear). Pennsylvania State Archives, RG-23.

  By December, almost 40 percent of the court-ordered patients housed in the maximum security wards in N-8 and N-9 had escaped. In a move to clean up the situation before neighborhood residents got wind of it, welfare secretary Arlin Adams urged another investigation. The Northeast Chamber of Commerce subcommittee chairman Albert Redles, in a letter to Adams, wrote, “Inmates are still escaping, and as you and I know, in all probability they never should have been committed to the institution. Nevertheless, they and others are in the Byberry buildings, and the state’s responsibility, I feel, is to keep them there until a decision concerning their cases have been rendered.” Adams asked for an appropriation of $450,000 to modernize the second floors of the two buildings into a more secure environment able to house violent criminals. His request, too, was ignored. Meanwhile, the state announced that it was choosing from three candidates to fill Sielke’s position. It soon narrowed in on one: former president of the American Psychiatric Association Dr. Daniel Blain.

  Maximum security buildings, N-9 (left) and N-8 (right), 1967. Temple University Urban Archives.

  In October 1966, when Dr. Daniel Blain climbed into the saddle as the new superintendent, he was certain that political influence still weighed on the patients, and he had a new attitude on how to fix Byberry. Blain was internationally known for his non-intrusive approach to psychiatry and would prove to be one of Byberry’s best administrators. He was born in China while his parents were serving as Presbyterian missionaries there. He was a graduate of Vanderbilt University School of Medicine, served with the U.S. Public Health Service during the war and later was a professor at the University of Pennsylvania. After Blain’s first one hundred days at Byberry, State Mental Health Commissioner William Camp sang his praises, stating he survived “one of the most difficult jobs in the world.”

  As a Philadelphian, Blain was well aware of Byberry’s horrific past, and as a superintendent, he sympathized with his predecessors’ “frustrated and discouraged” circumstances. He had heard about Byberry’s situation since his childhood and knew it as “the wastebasket of the city.” Now it was the largest mental hospital in the state, and he was at its helm. Though he admitted from the start of his position as superintendent that if Byberry’s operation was not drastically improved, “the level of psychiatric care in this city will suffer proportionally,” Blain was up to the challenge.

  One of Blain’s biggest challenges, he said, was the deterioration of the physical plant itself. The East Group was unusable except for a few buildings. “Some sort of crisis seems to arise three or four times every day,” he said. In the West Group, two buildings’ heating fans seized, resulting in the removal of patients into the hallway, where the chill was “less biting.” As a condition of Blain’s acceptance of the position, and at his personal insistence, his friend and colleague Dr. Franklin R. Clarke was brought onboard as assistant superintendent. Commenting on the population, which was 5,800 when he took the position, Blain said, “I still have some hope that we can reduce the rolls by 1,000 in my first year,” a goal he would achieve.

  During his time in charge, Blain oversaw the transfer of 90 percent of the hospital’s male patients from the decaying buildings of the East Group to the two large workers’ buildings, S-1 and S-2, and the discharge of the other 10 percent. While it may seem a step backward to cram almost 2,500 patients into two buildings, the new environment was like the Hilton compared to the E buildings. Governor Raymond P. Schafer, however, after visiting the men in S-1 and S-2, recommended the buildings be closed due to their physical condition while offering up no solution. This clearly frustrated Blain, who was putting everything he had into Byberry and making real progress. His goal was to bring the population down to 3,000.

  One of his notable achievements was the long-overdue release of patient Catherine Yasinchuk. Yasinchuk’s story was truly remarkable. She was a Ukrainian immigrant who had come to Philadelphia at a very young age. In 1921, police had found her on the street “babbling.” After briefly questioning Catherine and getting no apparent response, they took her for a psychiatric evaluation, and she wound up in Byberry. Catherine was a quiet, well-mannered patient at Byberry until 1968 when Blain, following blurry records on her, tried communicating in several different languages. When finally, a n
urse began speaking to Catherine in her native Ukrainian, her eyes lit up and she began relating her story to the nurse. The seventy-year-old patient told of her journey to America at the dawn of the First World War and her desperate experiences here. Coming to the country alone out of fear, speaking no English, she found life in the city crippling. She told of a man she had once loved in her early life, the child she had with him and both of their apparent deaths. This is the event, she said, that pushed her crying into the arms of police. Yasinchuk was released to a nursing facility, under the care of the translating nurse’s daughter, in 1969. She died in 1983.

  While on a tour of the hospital in 1967, Bucks County State Representatives Milton Berkes and James Gallagher voiced thoughts of a new state investigation. During their tour, led by Dr. Blain, who had forgotten his keys he recalled, they visited S-1 building, which employees had officially labeled “the snake pit.” It was “representative of Byberry’s worst conditions,” said Blain. As they approached the building, Gallagher called attention to the prevalent odor.

  “It’s the stench that first gets to you,” Blain said, describing the ward. “The smell is in the walls and floors, and you can never get it out.” He led the representatives up the entrance stairwell and, in an attempt to get the attention of a nurse, knocked on a window. A man approached the window from the inside. “Would you look for the nurse?” Blain asked loudly. “Will you tell the nurse that someone is here?” The man studied Blain for a few seconds, as if trying to solve a puzzle. “My name’s Charlie!” the man finally replied and then quickly disappeared back into the sea of noise inside.