To celebrate the new openness, the superintendents invited a leading neurologist, S. Weir Mitchell, to give the keynote speech at the association’s fiftieth annual meeting in 1894. The attendees had hardly settled into their chairs in the Philadelphia ballroom when Mitchell let everyone know he had no interest in a cease-fire. “Once we spoke of asylums with respect; it is not so now,” he informed the crowd. “We neurologists think you have fallen behind us, and this opinion is gaining ground outside of our own ranks, and is, in part at least, your own fault.”
Mitchell was just getting warmed up. His rhetoric now turned prosecutorial: Where, he asked, were the asylums’ scientific reports? Where was the internal give-and-take that characterizes any scientific endeavor? “You live alone, uncriticized, unquestioned, out of the healthy conflicts and honest rivalries which keeps us up to the mark of the fullest possible competence,” he said. “The cloistral lives you lead give rise, we think, to certain mental peculiarities…. One is the superstition to the effect that an asylum is in itself curative. You hear the regret in every report that patients are not sent soon enough, as if you had ways of curing which we have not. Upon my word, I think asylum life is deadly to the insane.”
Asylum life didn’t die that day, and wouldn’t die completely for another sixty years, but it’s fair to say that Mitchell’s speech marked a significant moment in mental health history, a kind of dividing line between the old ways and the new. Over the next thirty-five years, research and science became the new buzzwords of the psychiatric profession, medical schools created departments of psychiatry, and some of their most promising graduates joined the quest to understand the human mind. Psychiatry came out of the asylums and directly into the American consciousness.
In 1933, as part of Eloise’s one-hundredth-anniversary celebration, Eloise superintendent Thomas Gruber put his pen to paper and offered his thoughts about extraordinary changes that had taken place since the founding of the first Wayne County Poor House. Gruber, a big-eared, square-jawed native of Ohio who presided over Eloise from 1929 until his early death of a heart attack in 1949, waxed enthusiastically about his hospital’s growth, as might be expected, but his main focus was on something bigger.
“Within the last hundred years,” he wrote, “science and the useful arts developed more than during all the preceding centuries…. Railroads span the earth, palatial lake and ocean steamers sail into every port. The automobile industry has changed the mode of living…. Vast dams have impounded hundreds of millions of gallons of water for power and irrigation. Medicine and science have had a new birth….”
For all Gruber’s fervor about science’s advances, however, there was one field he did not mention at all in his exuberant report—psychiatry. This was not false modesty. It was possible to brag at length about advances in the physical sciences; the mind, however, was still the great mystery, in many ways as much of a mystery in 1933 as it had been a hundred years before.
Freud’s psychoanalytic theories, as influential as they were, had no particular relevance in the treatment of serious mental illnesses such as schizophrenia. Major changes were coming, though: By the end of the 1930s, medical research underway in Hungary, Austria, Italy, and Portugal would bring forth experimental treatments for schizophrenia, including shock therapy and lobotomies, that would alter the practice of psychiatry at nearly every mental hospital in the country for the better part of two decades, including Eloise, although not necessarily for the better. Meanwhile, Eloise psychiatrists Milton Erickson and Ira Altshuler would soon make names for themselves with less invasive treatments for lesser disturbed patients—Erickson in the field of hypnosis, and Altshuler with pioneering work in music therapy.
But in 1933, Thomas Gruber and his staff were treating their patients with essentially the same tools, with much the same outcomes, as the previous generation had. That didn’t mean, of course, that nothing had changed at Eloise. A visitor to the hospital in that year would see two major differences between the asylum of the nineteenth century and its successor, and both were significant: first, the hospital’s stated commitment to treating its patients humanely; second, the sheer size of its population.
The two were inextricably intertwined. Being humane, in the view of psychiatrists of this era, meant not leaving the mentally ill to languish in jail or poorhouses. It meant giving them the best treatment available, in comfortable surroundings—not just a warm bed with a roof over their heads, but in well-equipped, well-staffed facilities, with access to books, music, movies, and other diversions.
Psychiatry had become a growth industry in the early twentieth century, and the ever-larger insane asylums—they would soon lose the asylum label in favor of ones that would emphasize that medicine was now the mantra behind the asylum walls—were proof of the boom. Few institutions were booming more than Eloise. “The past 24 years have experienced an evolution so phenomenal as to be really startling,” Eloise’s bookkeeper, Stanislas Keenan, wrote in 1933, when he updated his 1913 history of the institution. “This expansion has not been a wish of the Board, but a compulsion.”
Unlike the shabby, slapdash construction of the nineteenth-century expansions, Keenan wrote, “the buildings erected during the period out-class in every way those of earlier times. They are massive, substantial and beautiful.” Even accounting for the built-in bias of the beholder, “beautiful” could be defended: The classic brick-and-column facades of the new buildings looked like they belonged on the cover of a catalog for a New England college, while the interiors borrowed elements from the most elegant of the grand hotels, with columns and floors of yellow Verona marble—many tons of Verona marble—that the designers had imported from Genoa, Italy.
These massive buildings matched the style and thinking of the era. They were more than residences—they were monuments, shrines to the philosophy that a society is judged by its treatment of its most vulnerable citizens and that this generation, unlike the last, was determined not to fail the test.
Yet at many institutions, including Eloise, comfortable surroundings could not change the uncomfortable reality that many patients would still languish for years, decades, even lifetimes, just as they had before, with no outside review of their cases, trapped in a system that would soon experiment with a variety of risky and questionable treatments in a desperate attempt to cope with the rising numbers of “inmates.”
Annie’s status as a temporary Eloise patient must have ended sometime after June 12, 1940, when Bolewicki filed his tie-breaking report suggesting that “a little treatment might help her somewhat.” If I could find out where she went to live among Eloise’s many lettered buildings, I might be able to narrow the search for someone who knew her. Wayne County might have no surviving record of her, but surely the Census Bureau would have one.
The 1940 census took place early in April, before Annie’s arrival on April 25, but she must have made it into the 1950 census. Although the actual enumeration sheets remain closed until seventy-two years after the census is taken, I learn that, for a $65 fee, the Census Bureau will search for an individual family member and extract the information, once it has proof of the family relationship. I mail off my Letter of Authority, and several weeks later, I tear open an envelope to find that, yes, Annie Cohen was a resident of Eloise in 1950. But no, there’s no indication of what ward she lived on, or in what building, or of any address at all.
I phone the Census Bureau’s office in Indiana, and a helpful researcher says the full sheets for Eloise did not list specific buildings or ward numbers, reinforcing Annie’s anonymity, her near invisibility. As far as the outside world was concerned, Annie had no fixed address. She wasn’t Annie Cohen, of I or J or L building. She was a patient at a mental hospital named Eloise, and that’s all the world needed to know.
Except, of course, that very few people even knew that.
Like other public institutions with roots in the almshouse and the asylum, however, Eloise remained a home for society’s outcasts—no
t just the mentally ill and the homeless, but also those who suffered from some infirmity: the blind, the deaf, and the senile. When Gruber took over as superintendent in 1929, he reviewed a ten-year expansion plan that his predecessor had left behind and declared it inadequate. He sent a new one to the Superintendents of the Poor, calling for $12.1 million in improvements, a hefty sum in those days, equivalent to more than $150 million in today’s dollars. But Gruber didn’t have much choice: He was looking at Eloise’s annual increase in population—a steady 10 or 11 percent—and wondering where he was going to put all these patients.
Then, in 1930, with Eloise’s indigent population ballooning and welfare lines growing longer every day in Detroit, Gruber told the Superintendents that plans for a new infirmary, on the books since 1927, had to be cast aside in favor of a much larger facility. Within a few months, a new proposal emerged for a dormitory with a capacity for more than 5,000 residents and total floor space of approximately 382,000 square feet, more than twice that of the U.S. Capitol building.
This new behemoth was N Building, the latest addition to the alphabetical list of residences at Eloise, home to the infirm and the newly homeless, mostly men who would later come to be known as the POGIEs, the “Poor Old Guys in Eloise.” Many were auto workers who had ended up on the streets after the Depression brought a majority of the assembly lines to a screeching halt.
In just 16 weeks during the summer and fall of 1930, construction crews of 350 worked almost around the clock to finish the first 2,600-bed phase. Despite this speed, the building couldn’t be completed fast enough to take care of the need. N Building filled to capacity and beyond as soon as the last nail was hammered; with Michigan’s winter temperatures regularly below freezing, beds were placed anywhere and everywhere as Eloise tried to cope with the crisis.
In 1931 and 1932, expansions doubled the number of beds as well as the size of the kitchen, which was thought at the time of completion to be the largest institutional kitchen in the country. To produce enough coffee for N Building’s battalion of residents, the kitchen installed six eight-gallon urns that sent an almost continuous flow of the brew into a two-hundred-gallon reservoir. That meant a supply of 3,200 cups of coffee on hand—a staggering amount but, remarkably, not enough to go around in April 1933, when the infirmary rolls showed 7,441 patients, including 1,500 residents who were “blind, crippled or otherwise infirm” and wouldn’t be leaving when the weather turned warm. That summer, and most summers during the Depression, the infirmary population routinely topped 4,000.
Inside the superintendent’s office, Gruber couldn’t quite believe the pace of change at his institution. In 1913, when Stanislas Keenan’s first history of Eloise was published, the institution had 1,400 residents. “Now, there is almost 9,000 and during the acute Depression, over ten thousand,” Gruber wrote for Keenan’s 1933 update. (Gruber arrived at the 10,000 figure by adding the 4,000 psychiatric patients and the 6,000 infirmary residents.)
The workforce had expanded at an even faster pace. “The employees then numbered 140, and now there are over ten hundred,” Gruber wrote. (On Gruber’s handwritten manuscript, now in the Michigan State Archives, Keenan penned in the exact number of employees, 1,632, above Gruber’s “ten hundred.”)
Among those 1,632 were six social workers who, while small in number, represented the vanguard in Eloise’s changing attitude toward the mentally ill. When the social work department opened in 1923, “the science of hospital social service was in its infancy,” Clark wrote in his 1982 history. “There were very few traditions to be followed because mental hospitals up to that time had been largely custodial institutions and less interested in the patient’s welfare than in keeping them removed from society. The Social Service Department helped make the transition from ‘asylum’ to ‘hospital’ due to its emphasis on the causes of the patient’s illness” and personal history.
The aim was admirable, but the workload was impossible. In 1923, Eloise’s mentally ill population had reached 1,700; ten years later, it had more than doubled. How could a handful of social workers delve into the personal history of that many patients? The social service department had to grow if the hospital expected it to accomplish anything, and grow it did, but never enough to keep up with the exploding psychiatric population. With nearly a thousand new admissions annually, each social worker was expected to produce detailed personal histories (like the one that Mona Evans did on Annie) on more than 130 patients each.
Gruber, as the product of the generation that had brought mental illness out of the nineteenth-century almshouses and placed it firmly into the medical arena, saw Eloise’s annual increase in population as a phenomenon without end. He could be forgiven for writing in 1933 that “it is quite certain that the expansion will continue indefinitely, for as Wayne County expands, so will Eloise.” He could not imagine, trapped in his time and place, that in fifty years, his institution would be emptied out, abandoned, and left to rot.
And it was unimaginable. The nation’s mental hospitals had more patients than ever, partly the consequence of new definitions of what constituted a mental disorder. During the first thirty years of the new century, the number of mentally ill residents in hospitals soared from 142,000 to 365,000, an astounding 163 percent increase, far exceeding the country’s population growth rate, which itself rose an impressive 65 percent (from 76 million to 125 million).
If big wasn’t necessarily better, it matched the tenor of the times, as one historian noted in a 1944 retrospective, a book of essays called One Hundred Years of American Psychiatry, published by the American Psychiatric Association to mark the founding of its predecessor organization. “This has been the era of big things,” wrote Samuel W. Hamilton, a mental health adviser with the U.S. Public Health Service. “Restraint on the size of institutions was thrown to the wind. Some able men uttered the dictum that it makes no difference how large an institution may be, that it is all just a matter of organization. California and Illinois deliberately planned institutions for six thousand patients. New York already had one of those and planned one for ten thousand….”
Eloise’s stated goal, appearing frequently in documents of the era, was to return patients to a useful life outside the hospital; every year, Eloise paroled as many as one-third of its population. That meant the hospital was sending about 1,200 people annually back to their homes and communities. Annie was not one of those 1,200. Why?
During one of my many interviews with Ed Missavage, I ask him for his best guess as to why that might be. “There are a variety of factors at work here,” he says, peering at me through his oversized bifocals. “First, we would look at her mental stability. Is she improving? Then, we would look at her family. Do they want her home? Are they able to take care of her? Finally, we would assess her ability to make it outside the institution on her own.”
He pauses, searches among his papers for a reference work, and continues when he can’t find it. “We’re talking about the first few years, in the 1940s, before medication came along. Right off, there would be a question about her mental stability, and you’ve got her mental retardation and her wooden leg problems. So there’s a question about whether she could make it on the outside. Then there’s her family. They don’t know what to do about her, so there’s probably no pressure from them for a parole.”
I look up from my note taking.
“Your family wasn’t asking for her to come home, right?” he says.
Her records suggest that’s probably the case. “Right, as far as I know,” I reply.
“So from our point of view,” Missavage continues, “she’s a custodial patient from the outset. She’s the type we don’t ever think is going home.”
{ EIGHT }
I Am Family
Family ties: Anna Oliwek’s postwar identification card, showing her maiden name (courtesy of Anna Oliwek)
The homework assignment seems clear enough: Do a family tree. I turn the paper sideways, and in no time at all, I’ve f
illed Dad’s side with brothers and sisters, aunts and uncles, first and second cousins, more than two dozen names from Michigan and elsewhere. I’ve met them all at one family gathering or another, so I can jot down their names and draw the lines without asking Dad or Mom for help.
On Mom’s side, though, I’ve reached a dead end after just three names—Mom, Bubbe, and Zayde. I’ve heard Mom mention an uncle, but I don’t know his name or where he lives, or whether he’s related to Bubbe or Zayde. And did Mom once say something about a cousin, or am I making that up?
I didn’t save that flimsy family tree, and try as I might, I can’t recall what happened when I attempted to fill the gaps in it—no memory of whether I asked Mom for the name of that uncle (I must have) or that cousin (did she dodge my questions?) or whether I was inquisitive enough (I can’t imagine that I was) to delve into my grandparents’ roots in Eastern Europe and the family they had left behind.
How old was I? I’m not sure, but eighth or ninth grade seems about right. Nevertheless, the exercise must have left its impression, because I can remember saying later to my college friends, in one of those where-does-your-family-come-from sessions, that I didn’t have much family on my mother’s side and that we just didn’t know anything about the place where my grandparents’ relatives lived in Eastern Europe.
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