OUT OF MIND, OUT OF SIGHT PDF Free Download

1 / 250
0 views250 pages

OUT OF MIND, OUT OF SIGHT PDF Free Download

OUT OF MIND, OUT OF SIGHT PDF free Download. Think more deeply and widely.

Out of Mind, Out of Sight
1
OUT OF MIND, OUT OF SIGHT
A Revealing History of the
Florida State Hospital at Chattahoochee and
Mental Health Care in Florida
SALLY J. LING
Sally J. Ling
2
Copyright © 2013 by Sally J. Ling
All rights reserved.
No part of this book may be used or reproduced in any manner whatsoever
without written permission of the author, except in the case of brief
quotations embodied in critical articles or reviews.
To contact the author, visit her website at sallyjling.com.
Cover design by Susan Rosser
ISBN-13: 978-1480101517
ISBN-10: 1480101516
Out of Mind, Out of Sight
3
ACKNOWLEDGEMENTS
Writing a book of this scope takes many years and a massive amount of research.
Assisting me with this project was Tara Newman, a former graduate student and
intern from Florida State University. To her I extend my deepest appreciation.
I would also like to thank Diane James, former administrator of the Florida
State Hospital, for access to hospital archives and photos, providing current
hospital information, and arranging the interview with Mrs. Rogers.
I am most grateful to my readers and extend my sincere gratitude to Pat
Keeley for her assistance with story line, and editing, and Joyce Manning for her
superb final editing.
Sally J. Ling
4
Out of Mind, Out of Sight
5
Foreword 7
Introduction 13
Chapter I Recipe for War 15
Chapter II Housing Convicts 25
Chapter III Philadelphia to Florida: The Roots of
Institutionalized Mental Health Care 37
Chapter IV Florida’s Response to the Mentally Ill 53
Chapter V Transforming the Prison into an Asylum 57
Chapter VI Entering the 20th Century 71
Chapter VII New Therapies Stir Hope and Skepticism 83
Chapter VIII Lobotomies: Cutting Edge Brain Surgery 97
Chapter IX Hope and Challenges 111
Chapter X Procedural Status Quo, Medical Discoveries,
and the Wind of Change 125
Chapter XI Two New State Hospitals Added 139
Chapter XII Investigation 145
Chapter XIII Landmark Changes Come to Florida 157
Chapter XIV Risk and Reward 171
Afterword 183
Postscript 185
Appendix 195
Endnotes 223
Index 241
About the Author 248
TABLE OF CONTENTS
Sally J. Ling
6
Out of Mind, Out of Sight
7
FOREWORD
I arrived in Tampa, Florida, in 1966 as a college freshman to attend the University
of South Florida. My father, having just retired from the Air Force, built a lovely
home for our family of five in the northern part of the city across from Lake
Magdalene and next to a producing citrus grove. Having recently returned to the
United States from three years in Japan, however, we found the Sunshine State quite
foreign.
My sisters and I spent our first Christmas frolicking in the pristine spring
fed lake behind our home. That was until Dick Butler, the old citrus farmer next
door, ran down to the water’s edge frantically waving his arms and pointing to a
large alligator swimming toward us from across the lake. After making it to shore,
we breathlessly listened as the farmer chastised us: “You girls should be sent to
Chattahoochee for being crazy enough to swim with a gator that close.”
Unfamiliar with the term “ChattahoocheeI asked the sun-wrinkled farmer
what it meant. He simply hiked up his overalls, rolled his eyes and made several
circles with his dirt-encrusted index finger at his temple. “Loony bin,” he stated
Tampa
Miami
Jacksonville
Tallahassee
FLORIDA
Sally J. Ling
8
flatly. Then he leaned in real close, “And you never want to go there.” His piercing
hazel eyes emphasized his caution.
From then on, every time I heard the word “Chattahoochee,” I knew what it
meant—the Florida State “Mental” Hospital at Chattahoochee. Located in a small
town about forty-five miles west of Tallahassee, the capital of the state, it was an
isolated facility steeped in dark secrets . . . a place where parents jokingly threatened
to send their kids if they didn’t behave.
In those days the facility had quite a reputationmost of it bad. But the
institution wasn’t alone. For decades throughout the country, state facilities earned
shocking reputations for their inadequate care and mistreatment of the mentally ill.
Even more chilling was the incarceration of thousands of men and women who were
not mentally ill at all, but due to ignorance and prejudice on the part of the public,
medical profession, and court system, were confined for sunbathing nude, smoking,
menopause or other ‘egregious’ offenses committed by those deemed mentally
deficient.
Unfortunately, the sensational stories that surfaced from these institutions
tended to overshadow the positive work performed by the facility’s dedicated
medical and professional staff in helping thousands of patients assimilate back into
productive society. On the other hand, it was precisely those sensational stories that
led to changes in commitment procedures, care, and treatment of tens of thousands
sent to mental institutions throughout the country.
The following is a history of the Florida State Hospital at Chattahoochee
from construction of its original buildings in 1834 as part of the Chattahoochee
Federal Arsenal, to its current role, treating individuals who have been civilly and
forensically committed (inmates who have been adjudicated through the criminal
justice system to be incompetent to proceed, or not guilty by reason of insanity).
The buildings themselves give us a remarkable glimpse into the early
history of Florida and its transition from territory to state. As well, the facility’s
many different uses reveal shifts in the needs of Florida citizens as the buildings
evolved from federal arsenal to state penitentiary to mental institution. So important
are the buildings to the overall history of Florida that of the two remaining original
arsenal structures, the William DeWitt Rogers Administration Building, originally
Officers Quarters and one of the oldest structures of its kind in Florida, has been
restored and is listed on the National Register of Historic Places. The other, an old
powder magazine where munitions were warehoused, is currently being restored.
Out of Mind, Out of Sight
9
Above: Outside of the restored Chattahoochee Arsenal powder magazine. Below: Inside the
powder magazine. Photos courtesy of Joe Blanton and the Florida State Hospital.
Sally J. Ling
10
History of the buildings aside, this story chronicles for the first time how
Florida dealt with its mentally ill citizenry, and how in the post-World War II era the
state’s burgeoning number of citizens committed to the facility required the Florida
State Hospital to expand from one remote institution into four statewide hospitals. It
also shows how a shift in philosophy regarding treatment of those diagnosed with
mental illness encouraged the nation to transition from state institutions to
community-based mental health treatment centers. (While this book includes the
evolution of mental health care in Florida, it is not intended to be an in depth study
of the topic.)
To put the Florida State Hospital at Chattahoochee in perspective, the story
is set against a backdrop of the evolution of institutionalized mental health care both
in the U.S. and Florida where new emerging treatmentsinsulin, Metrozol and
electroconvulsive (ECT) shock therapies, as well as lobotomiesbecame part of
patient treatment plans. It also includes the most compelling medical discovery in
the evolution of patient treatmentThorazine, a psychotropic drug. Called a
“chemical lobotomy, this drug, and others to follow, changed the face of mental
illness treatment forever.
Restored William DeWitt Rogers Administration Building. Photos courtesy of the Florida State
Hospital.
Out of Mind, Out of Sight
11
Despite all the medical advancements, one of the most fascinating
revelations to come out of the hospital’s history is the saga of patient Kenneth
Donaldson. Recounted in his book, Insanity Inside Out, his 15 year struggle for
justice took him from the Florida State Hospital, to Florida’s local and state courts,
and all the way to the United States Supreme Court. His multi-year journey
ultimately resulted in sweeping changes in commitment procedures at the Florida
State Hospital and mental institutions nationwide. Another patient, Emette Foley,
took his experience at the Florida State Hospital to Hollywood, California, where it
ended up on the silver screen in the 1991 movie “Chattahoochee.
The Florida State Hospital has an amazing history, but for us to truly
understand the facility’s remarkable past and how it became what it is today, we
need to return to the early 1800s and the circumstances that led to its construction.
It is there that the story begins.
Sally J. Ling
12
Out of Mind, Out of Sight
13
INTRODUCTION
For decades during the 1800s, Native American Indians were systematically routed
by government troops in an effort to move them west into the Arkansas/Oklahoma
territory where reservations had been established. During this time, thousands of
Indians perished in battles, and remnants of surviving tribes in the southeastern
United States were pushed far into the south toward Florida, a territory under
Spanish control.
While some of the Indians became friends with American colonists and
federal troops and lived peaceably among them, even joining forces against other
Indian tribes, others resented being ousted from their lands and looked upon the
intrusive white man as their enemy.
Chapter Photo: Neamathla, 1836. Courtesy of the Florida State Archives.
Sally J. Ling
14
Skirmishes sparked by this enmity broke out periodically between the
Indians, colonists, and federal troops, resulting in many casualties on both sides.
Forts, built along primary waterways used as main supply and transportation routes,
soon became fortified with U.S. troops, provisions, and munitions in defense against
the Indians.
Creek Indian Chief Neamathla, who as a warrior had been defeated earlier
in the Red Stick Rebellion of 1813 by a rival Creek tribe supported by General
Andrew Jackson and U.S. troops, was forced to move south and now occupied land
at Fowltown, Georgia. Believing the land was available for occupation as part of a
treaty signed between the U.S. and the British to end the War of 1812, Neamathla
settled in. The U.S. government, however, now demanded that the chief and his tribe
give up this land and relocate once again.
With Neamathla unwilling to vacate the disputed land, Major General
Edmund P. Gaines, a hero of the War of 1812 and overall commander of the region,
ordered Major Twiggs and 250 of his men from Fort Scott, Georgia, to march on
Fowltown, just 15 miles to their east, and bring in the defiant chief by force.
1
On the night of the attackNovember 21, 1817Neamathla noticed
movement outside his village and struck first against the waiting troops. The
skirmish failed to capture the chief, and two days later U.S. troops struck again.
While the Indians were driven from their village, for a second time Neamathla
managed to escape. In the aftermath of these two skirmishes, hundreds of warriors
from nearby Lower Creek and Seminole Indian villages joined forces with the
elusive chief.
A week later, a small military supply flotilla traveled up the Apalachicola
River from the Gulf of Mexico on its way to Fort Scott.
2
What happened next
proved to be a turning point in Florida history and prompted the construction of a
compound that eventually became the Florida State Hospital.
Out of Mind, Out of Sight
15
Chapter I
Recipe for War
November 30, 1817
Lieutenant Richard W. Scott of the 7th U.S. Infantry deftly commanded his boat
loaded with forty soldiers, seven of their wives, and four children up the swollen
Apalachicola River in the panhandle of Spanish Florida, heading to Fort Scott,
Georgia. Having rendezvoused downstream near Bristol, Florida, with a small
supply flotilla commanded by Major Peter Muhlenburg of the 4th U.S. Infantry,
twenty of Lieutenant Scott’s able-bodied men had recently exchanged places with
members of the supply boat who were sick with fever. Lieutenant Scott would
deliver the pallid troops to the Georgia fort where they could recover. The
exchanged troops would assist Muhlenberg in continuing his mission of bringing
lifesaving supplies to the same fort.
Chapter Photo: General Andrew Jackson, Courtesy of the Library of Congress, LC
3a52040u.
Sally J. Ling
16
Well aware of recent skirmishes between U.S. troops and Indians at
Fowltown, it is unclear why Lieutenant Scott headed upriver independent of the
flotilla or why he ignored warnings from plantation owners Edmund Doyle and
William Hambly that Indians were amassing at the river junction with the intention
of attacking the supply boats. He had even dispatched a courier over land to Fort
Scott with a letter to his superiors notifying them of the possibility of such an
assault; and, he indicated grave concern regarding his unarmed men’s ability to put
up any sort of defense.
3
Still, he proceeded.
As the boat navigated a sharp bend near the present-day site of
Chattahoochee in what is now Gadsden County, the strong current required the men
to guide their vessel close to the shoreline. It was there, hidden along the riverbank,
that several hundred Seminole Indians lay in wait, led by Red Stick Chief
Homathlemico, whose warriors had joined forces with Neamathla.
4
The Seminoles, a heterogeneous tribe who called themselves yat'siminoli or
"free people,” were made up of Lower Creek Indians retreating from previous wars
with the U.S. government in Alabama, Georgia, and Louisiana, and a number of
other tribes including Red Sticks and Mikisuki (now Miccosukee). Joining them
were numerous African-American slaves who had escaped plantations in Georgia
and the Carolinas.
Building villages near the Seminoles, the slaves established a strong
friendship with the Indians, intermarried, and eventually formed a union to mutually
resist the white man’s attempts to drive out the Indians and return the black slaves to
their owners. So closely allied were these two groups, that the escaped slaves
became known as “Black Seminoles.” It was into this alliance that Lieutenant Scott
unwittingly captained his boat.
5
In the initial attack from shore, Lt. Scott and most of his men were slain.
Then, wielding knives and hatchets, the Indians stormed the boat and massacred
those who remained.
6
Four men wounded in the initial attack escaped by jumping
into the river; but the children weren’t so fortunate. Personal letters from officers at
Fort Scott reported that the children were killed when “picked up by their feet and
swung against the sides of the boat until their brains were dashed out.” Later, a most
gruesome discovery was made when the scalps of both male and female victims
were found hanging in a Seminole village near what is now Tallahassee.
7
On December 4, 1817, General Gaines sadly, yet resolutely, reported the
violence to U.S. Secretary of War John C. Calhoun. His letter stated that the attack
Out of Mind, Out of Sight
17
was far more severe than those previously committed, and he now called for the
immediate application of force.
8
While peace was actively pursued, the Seminoles, who considered the
Florida territory their home, became increasingly intolerant of the white man’s
intrusion and the massacre of Lieutenant Scott and his men was just one in a long
string of attacks the Seminoles made against military forces and white settlers with
subsequent retaliation by U.S. forces. With this attack, however, tolerance for the
Indians had worn thin.
Gaines’ letter to Calhoun continued:
. . . I would much more willingly devote my time and humble
faculties in the delightful occupation of bringing over savage man to
the walks of civil life, where this is practicable without force, than
to contribute to the destruction of any one of the human race; but
every effort in the work of civilization, to be effectual, must accord
with the immutable principles of justice. The savage must be taught
and compelled to do that which is right, and to abstain from doing
that which is wrong. The poisonous cup of barbarism cannot be
taken from the lips of the savage by the mild voice of reason alone;
the strong mandate of justice must be resorted to and enforced.
After all that the wisdom and philanthropy of our country and
Government, aided by millions of money, have yet been able in
effect, it is a melancholy truth, that in no Indian nation within my
knowledge, (the Chickasaws excepted), has the scalping knife been
laid aside for any considerable length of time, until their every hope
of using it with impunity has been defeated.
9
Several weeks later, Secretary Calhoun sent an urgent message to Major
General Andrew Jackson in Nashville, Tennessee. Just two years removed from his
victorious command against the British in the Battle of New Orleans, the General
was immediately ordered to Fort Scott where he was to take command of 1,800
men900 Georgia Volunteers, a detachment of gunmen from West Tennessee, and
friendly Creeks under the direction of half-breed Chief McIntosh.
10
Calhoun’s letter
emphasized that, because of increased hostilities by the Seminoles, Jackson might
find it necessary to concentrate his whole force in their direction. If, however, the
force proved too small, Calhoun gave the General complete authority to call upon
adjacent states for whatever troops were necessary.
11
Sally J. Ling
18
Routing the Indians
Mounted on his dapple grey steed, the indomitable General Jackson boldly
stepped across the Georgia border into the primitive Spanish-controlled territory
known as Florida. With Spain unable to defend Florida’s expansive frontier, the
U.S. government was confident the land could be opened to white settlers without
interference; however, in order to protect those settlements already established and
to open the land to new colonists, the government needed to put an end to the Indian
attacks. Their solution: Eliminate Native American villages established by the
Seminoles.
Over the next several years, General Jackson set ablaze numerous
indigenous villages all the way to the Suwannee River, captured hundreds of former
black slaves, and hanged three menan Indian medicine man and two Englishmen
suspected of supplying munitions and provoking the Indians to war with the U.S.
Known as the First Seminole War, these tragic series of conflicts, which ran from
1814 to 1818, set the stage for subsequent Indian wars and prompted the U.S.
government to fortify northern Florida.
12
Spain ceded Florida to the U.S. in 1821, and through the Territorial Act of
1823, Gadsden was established as Florida’s fifth county, one that stretched from the
Georgia border to the Gulf of Mexico. James Gadsden, for whom the county was
named, was an army engineer who later became aide-de-camp to General Andrew
Jackson during the First Seminole War. He also designed and built Fort Gadsden, an
important stronghold on the Apalachicola River; and, in 1853, while serving as
Ambassador to Mexico, he completed the Gadsden Purchase. This transaction added
45,535 square miles of territory along the southern Arizona and southwestern New
Mexico borders that became the last major territorial acquisition in the contiguous
United States.
13
With Florida now a territory of the United States, Jackson became military
governor. During his 10-month service, and continuing over the next decade, several
treaties were proposed to the Seminoles. As well, U.S. Indian Agents encouraged
them to abandon their villages and move west of the Mississippi River to the
Arkansas Territory. The Native Americans, however, would not budge. To help
convince them, in 1830, Jackson, now president of the United States, pushed
through Congress The Indian Removal Act
14
a decree the Seminoles met with
fierce resistance.
Out of Mind, Out of Sight
19
The Apalachicola/Chattahoochee Arsenal
Knowing that a second clash with the Seminoles was inevitable, the federal
government looked for strategic locations to build a number of ordnance depots.
With orders from Colonel George Bomford, Chief of Ordnance, Lieutenant John
Hills of the 4th U.S. Artillery arrived to survey a section of Florida between the
Apalachicola and Suwannee Rivers in order to identify a suitable location for an
ordnance depot where arms and munitions could be stored.
15
After an initial
assessment, Hills suggested that the facility be built along the Apalachicola River
and upgraded from a depot to an arsenal capable of ammunition preparation and
weapon repair.
With the appropriation of $20,000 from the army in 1832, Hills, who had
been recently promoted to Captain, selected the present day site of the Florida State
Hospital for the arsenal because of its high ground and close proximity to the
Apalachicola River. Subsequently, Jackson issued the order to reserve the specified
land in the public domain near the small town of Mount Vernon.
16
The town was originally a trading post along the Old Spanish Trail at the
Apalachicola River. At the time of the first census in 1825, Robert Forbes, tax
collector, noted the population of Gadsden County was 1,376815 whites and 561
“negro” slaves. On March 6, 1828, the first post office was established at Mount
Vernon with John McCullock, a river ferry operator, appointed postmaster. Along
with the establishment of the post office, E. H. Calloway prepared a survey of the
town. The grid, laid out in rectangles, outlined several different sized lots from 52’ x
104’ up to one acre. Seven named streets were documented with Washington,
Jefferson, Marion, and Bolivar Streets depicted as they exist today.
17
Because a Mount Vernon Arsenal had already been established in Alabama,
communications between Captain Hills and Washington regularly became
misdirected. To alleviate the confusion, the Captain convinced the Legislative
Council in Tallahassee to change the town’s name from Mount Vernon to
Chattahoochee (the Cherokee word Chat-to means stone and ho-che colored or
marked). After the name change in 1834, the arsenal became known as the
Chattahoochee Arsenal, or Apalachicola Arsenal.
18
As there was no suitable stone in the vicinity to use for construction, brick
proved to be the most viable option. In short order, a brick-making plant, contracted
out to Benjamin Chaires of Tallahassee, was built along the river bottom with the
expectation that it would produce 350,000 bricks per month; but, because the owner
Sally J. Ling
20
Sketch of the Apalachicola/Chattahoochee Arsenal, 1839. Photo courtesy of the Florida State
Hospital.
had no prior experience in brick making, the first firing proved untenable. Realizing
the alluvial clay required heavy tempering with sand, Chaires began experimenting.
After an eight-month delay, enough bricks were finally delivered to the site, and
construction got underway in the spring of 1834.
19
By July 1834, the walls of the Arsenal and tower had been erected and
covered by a suitable, yet temporary, roof; however, sweltering summer heat,
compounded by fever among the workers, prevented them from continuing, so work
was suspended and the laborers discharged. The brick factory, however, continued
production, and by the end of the year, 500,000 suitable bricks had been delivered to
the site. Construction resumed in the spring of 1835 using English immigrant
bricklayers.
20
By all accounts, the arsenal was a well-constructed facility built of lilac-
colored brick and situated in aesthetically pleasing surroundings, as described by an
anonymous traveler in the December 5, 1835 issue of the Tallahassee Floridian:
Out of Mind, Out of Sight
21
. . . It is a splendid structure, the brickwork of the main building,
already completed, and wall, when finished, give the place an
interest and worth, it could never otherwise possess. The scenery,
as observed from the tower, is beautiful and picturesque. A rapid
glance, as far as the eye can stretch on the boarder of the horizon,
could not fail to animate the poetic and delight the romantic; but to
my less brilliant genius, the appearance, presented (the inequality of
the height of trees being lost in the distance) was that of a green
wheat field broken by easy declivities, and gently swelling hills.
21
The untimely deaths of Captain Hills in February of 1835 and his
replacement Lieutenant Charles Petigru in October of the same year, resulted in the
appointment of Lieutenant John Williamson, whose charge it was to complete the
arsenal. The two deceased officers were buried in Mosquito Creek swamp, a site
near what was later to become the cemetery for deceased patients of the Florida
State Hospital.
22
When complete, the arsenal cost a total of $226,932.50
23
and consisted of a
four-acre quadrangle with nine buildings: three workshops, barracks, officer’s
quarters, guardroom, office, gun carriage storage building and an octagonal five-
story tower, at the time the tallest building in Florida. Surrounding the compound
was a nine-foot-tall by thirty-inch-thick perimeter wall. Completing the complex
were four outer buildings, including two gunpowder magazines, a laboratory and a
sutler’s store,
24
a civilian-owned store that sold provisions to the army.
The Second and Third Seminole War
Almost 4,000 Native Americans had made the forced move to the Arkansas
Territory, also known as Indian Country, by 1834. Seminole Chief Osceola,
however, vowed to fight on. Because of his resistance, he was briefly imprisoned.
Shortly after his release, he resumed attacks. On December 28, 1835, Osceola
murdered Indian agent Wiley Thompson. That same day near Fort King (Ocala),
300 Seminole warriors ambushed a contingent of 107 U.S. soldiers led by Major
Francis Dade, for whom Miami-Dade County was named. Thus began the Second
Seminole War.
25
By the time Seminole and Creek Indian attacks reached settlements around
the Chattahoochee arsenal in 1839, the facility was fully operational. It was there
settlers are said to have found refuge following raids by the Indians into nearby
Sally J. Ling
22
Seminole Indians attacking a fort (possibly Fort Clinch) on the Withlachoochee River (1935).
Photo courtesy of the Library of Congress, LC-DIG-ppmsca-19924.
settlements, such as Liberty County where more than a dozen men, women, and
children were slain and their homes and farms set ablaze.
26
The arsenal also lent its
munitions to local volunteers setting out to look for the murderous Indians.
27
The war ended in 1842, when 4,420 Seminoles surrendered and were
deported to Oklahoma. The remainder of the tribe hid out in the Everglades under
the leadership of Chief Billy Bowlegs; however, peace was short lived. Fighting
broke out again in 1855, when Bowlegs retaliated against a military surveying party
that had ravaged his banana trees. Thus began the final confrontationthe Third
Seminole Warthat lasted until 1858. Though most of the Seminoles surrendered,
many forged deeper into the Everglades and never capitulated. They and their
massive casino enterprise are still there.
As the bloodshed subsided, military storekeepers managed the arsenal’s
arms and munitions and additionally maintained the grounds and buildings;
however, by 1861 only a small military party of four manned the complex. The
arsenal, though, would soon play a role in a larger conflict, one that pitted neighbor
against neighbor and father against sonthe Civil War.
Out of Mind, Out of Sight
23
The Arsenal during the Civil War
For decades, philosophical and political differences placed the North and
South at bitter odds. With the election of Abraham Lincoln as president, those
differences boiled over, and southern states began systematically seceding from the
Union. As the Florida legislature prepared for secession, gaining control of the
arsenal at Chattahoochee was imperative. In question, however, was just what kind
and how much ordnance remained there.
U.S. Florida Senators David Levy Yulee and Stephen Russell Mallory sent a
joint letter to Acting Secretary of War General Joseph Holt requesting an inventory
of the arsenal. Knowingly suspicious of the Senators’ request, Holt kept the
inventory to himselfone six-pounder iron gun and carriage with 326 shots and
canisters for same, 57 flintlock muskets, 5,122 pounds of powder, 173,476
cartridges for small arms, and a quantity of different kinds of accoutrements
28
and
notified the senators that because of the sensitivity of the information, it would not
be made public.
29
In the meantime, on January 5, 1861, Florida’s Governor Madison Starke
Perry sent out secret orders, and a Gadsden County Military unit known as the
“Young Guards immediately left for the arsenal. When they arrived, they were
surprised to find only three soldiers manning the post. Without the discharge from a
single weapon, the Florida Militia took possession of the facility. Four days later,
Florida seceded from the Union.
30
The arsenal became the gathering place for companies of militia sent to
defend various forts both in and out of Florida, and on April 5, 1861, several of the
companies were inducted into service with the Confederacy as the First Florida
Infantry. Their service would last one year.
31
After the War
Believing there was more than enough room to accommodate substantial
faculty and as many as 300 cadets, at the end of the war in 1865, Governor John
Milton recommended that the state convert the arsenal into a military academy and
state arsenal. The assembly disregarded Milton’s recommendations and transferred
the arsenal from the Ordnance Bureau to the Bureau of Refugees, Freedmen, and
Abandoned Lands, more commonly known as the Freedmen's Bureau.
32
A
subsidiary of the War Department, the Bureau assisted in relief efforts relating to
Sally J. Ling
24
refugees and freed slaves called “freedmen,” including the issuing of food, clothing,
and medicine. The Bureau also assisted freedmen in regaining custody of lands
appropriated by former Confederate States.
33
In the aftermath of the war, Southern States, including Florida, experienced
great disorder with local jails unprepared for the confinement of so many sentenced
prisoners.
34
In light of this, Florida’s Governor Harrison Reed personally appealed
to both the Secretary of War and the Freedman’s Bureau to use the arsenal as a state
penitentiary. His idea was to lease the inmates as laborers based upon a system that
would both punish and reform the criminals while, at the same time, generating
revenue for the state.
35
The 41st Congress approved the request and donated the arsenal to the State
of Florida.
36
The Freedman’s Bureau subsequently closed its doors, and the former
arsenal at Chattahoochee became Florida’s first state penitentiary—a move that
would produce scenes one could only find in a horror film.
Out of Mind, Out of Sight
25
Chapter Photo: Florida State Prison, ca. 1925 Courtesy of the Florida State Archives.
Chapter II
Housing Convicts
The first prisoners shuffled into the Florida penitentiary at Chattahoochee in 1868;
and, while the nine inmates along with their 14 guards initially occupied the former
arsenal, it was less than fit for those few inhabitants, let alone the several hundred
future inmates for which it was intended. The buildings were in a total state of
disrepair with windows and shutters missing, doors barely hanging on their hinges,
roofs devoid of waterproof leading, and everything useful carried away. Little better
than ruins, the dilapidated structure was anything but a secure place to confine
criminals.
37
In fact, due to the lack of cells the prisoners were herded together at
night in one common dormitory.
38
During the day, convicts plowed land adjacent to the prison in order to
establish a farm. The intention was to provide meat, milk, and fresh vegetables for
the inmates and for the farm to become self-sustaining by selling crops, produce,
and dairy products to local residents. While some of the inmates worked on the
farm, others were assigned work off prison property for which the prison was paid
for their labor. This income helped offset the expenses of running the prison.
39
Sally J. Ling
26
Malachi Martin, 187?. Photo courtesy of the Florida
State Archives.
Malachi Martin: First Prison Warden
Colonel Malachi Martin, a former military man and one of Florida’s leading
carpet baggers during reconstruction,
40
became the prison’s first warden. His rein
would be mired in controversy, rumors of unspeakable cruelty, and good ol boy
Florida politics.
Born in Ireland in 1822, Martin immigrated to the U.S. at the age of 25 and
became a dry goods merchant in New York City. He entered military service in
December of 1861 and became an officer in the Union Army, serving both in New
Orleans, Louisiana, and Key West, Florida. Ordered to the headquarters of the
District of Florida in Tallahassee, he assumed duties as chief quartermaster on the
staff of Brigadier General John Newton a few months after Federal troops occupied
the state capital.
41
After the war, he was discharged. Instead of returning to New
York, true to the persona of a carpetbagger, Martin saw opportunity in Florida and
remained to invest in both its economic and political promise.
Out of Mind, Out of Sight
27
At first, he engaged in several agricultural ventures around Tallahassee.
Proving inept as a farmer, however, he subsequently made his entrée into politics. In
May 1868, he became an agent of the Bureau of Refuges, Freedmen, and
Abandoned Lands, serving as bureau agent in Leon and Wakulla Counties. When
the Freedman’s Bureau closed, Martin used his military connections to gain
appointment as warden of the penitentiary at Chattahoochee.
42
The Prison’s First Inmate Arrives
Calvin “Cy” Williams, an African American, arrived at the Chattahoochee
penitentiary in November 1868. Entered into prison records as “No. i,
43
the prisons
first inmate, he was there to serve a sentence for committing a felony. While several
references address Williams arrest and incarceration, they conflict in his age and
length of stay. The prisoner record book reports his age as 40; however, J.C. Powell,
in his book The American Siberia, Or Fourteen Years' Experience In a Southern
Convict Camp gives an entirely different account and shares a vivid look at his
incarceration at Chattahoochee:
He did not know his age, but when he was a mere pickaninny,
running about in the one garment that forms the costume of all
negro youngsters in the South, he was arrested for stealing a horse.
He was not large enough to mount the animal, and was caught in the
act of leading it off by the halter, for which he was duly sentenced
to twenty years imprisonment.
44
Because of his small size and the fact that Warden Martin had never had
such a young inmate, Powell noted that Williams was assigned a most monotonous
task during his daylong work shiftcarrying bricks from one end of the prison yard
to the other. Martin placed two pairs of bricks at opposite ends of the yard and gave
Williams a third pair. He was ordered to transport the two bricks to one of the piles,
put them down, pick up the two other bricks, and return to the first pile. He was to
continually make the exchange, always carrying two bricks, and was warned he
would be whipped should he not complete this task, not pile the bricks neatly, or
broke any of the bricks. The mere repetition of the task wore out four sets of bricks
before prison authorities assigned him an alternate chore.
45
According to Powell, after 17 years Williams was finally released with
almost three years shaved off his prison term, the result of gain time, the earning of
sentence reduction for good behavior. (Earning three days for each month a prisoner
Sally J. Ling
28
had not been punished, prisoners could earn an additional five days each month for
good work performance and adhering to prison rules.)
46
Williams wasn’t the only youth to be locked up at the ill-kept prison. In an
annual report, Martin wrote to the Adjutant General of the State of Florida that there
wasn’t one room where convicts could be safely locked up without a guard.
Additionally, he expressed concern that young boys sent to Chattahoochee for what
he considered to be a “trifling crime,” had to occupy the same dormitory as the most
hardened criminals. To support his apprehension, he noted that even criminals with
good conduct records often remarked that they would rather be assigned hard labor
than be confined with the worst prisoners in the same room.
47
Prison Receives Indigent Insane
By 1873, the prison facility at Chattahoochee housed 82 convicts: 14 white
males, 65 “colored” males, and three “colored” females. Among them was Betsey
(also spelled Betsy) Yulee, an African American from St. Augustine, who arrived on
June 23, 1870, as the facility’s first “insane” resident. She wouldn’t be their last.
Over the next several years, other mentally ill patients were sent to the prison until a
more suitable place could be provided.
48
Among them were Nancy Monroe (39,
black), who arrived in 1874; Jane L. Buford (37, mulatto-mixed white and black)
and Mooney Floyd (35, black), who arrived in 1875; and the trio of Charles Baldwin
(40, black), Sharpless Evans (17, white), and Henrietta Wilson (20, black), who
arrived in 1876.
49
Unhappy being charged with care of the state’s mentally ill, Martin made
his feelings known in a letter to the State Legislature:
I have agreed to take them and give them such care as we could,
simply because they could not be otherwise provided for [but] wish
to say right here that there is no suitable place for such unfortunates,
and I hardly know how to express my feelings on the subject. They
are simply held here, get plenty to eat and clothing to cover them
comfortably, with a good house to live in. But as to means of
treating such persons as they ought to be treated, I hold that we have
none . . . I feel that it is inhuman not to provide a suitable asylum
for our insane, and that the authorities will be held responsible
hereafter for a gross neglect of their official duty if such an asylum
is not provided.
50
Out of Mind, Out of Sight
29
David Levy Yulee, Photo courtesy of the
Library of Congress, LC-BH82- 5271 B
Even the surgeon of the state prison, W.J. Scull, wrote to the legislature
bemoaning the fact that “lunatics” were confined to the prison and implored those
governing to devise a plan for their care. He laid the blame for the present
predicament directly at the feet of the legislature, noting that they had been informed
repeatedly of the need for adequate care of the mentally ill yet had turned a deaf ear.
He also left them with a dire warning--“As we sow, so we must reap.”
51
It would be several more years before the State Legislature acted upon those
pleas.
Yulee More than a Patient
Aside from Betsey Yulee being
the first insane patient at Chattahoochee,
it is her last name that leads us on a
curious journey, one that connects her to
one of northern Florida’s early white
pioneersDavid Levy Yuleea railroad
mogul, plantation owner, and Florida’s
first Senator. (Yulee was the same
staunch supporter of the Confederacy
who sent the letter to Secretary Holt
requesting information on the status of the
arms at the Chattahoochee Arsenal.)
Born David Levy on June 12,
1810, in Charlotte Amalie, St. Thomas, in
the Dutch West Indies (now part of the
U.S. Virgin Islands), he was the son of
Moses Elias Levy, a wealthy and
cultivated merchant who descended from
a long line of influential Jewish courtiers
to the sultans of Morocco.
A prominent Caribbean merchant, Moses Elias Levy traveled to Florida
where he purchased substantial acreage near Micanopy, Florida, in Alachua County
and established Pilgrimage Plantation, a large sugar plantation. It was there as a
young man that David Levy learned the sugar business, a lesson that would prove
most beneficial later in his life.
Sally J. Ling
30
Drawn to the legal profession, David Levy moved to St. Augustine, where
he studied law under Robert Raymond Reid. He passed the bar at age 22 and later
helped Reid became territorial governor of Florida. A staunch supporter of
statehood, David Levy became a member of the Florida Legislative Council in 1836.
In 1845, when Florida became a state, he served as Florida’s first Democratic
senator and the state’s first Jewish senator.
In 1846, shortly before David married Nannie C. Wickliffe, daughter of
Charles A. Wickliffe, former governor of Kentucky and Postmaster General under
President John Tyler, he added the name Yulee, his grandfather’s Sephardic Jewish
name, to his own to become David Levy Yulee. He also converted to Christianity.
In 1855, David Yulee began construction on the Florida Railroad, the first
cross-state railroad from Fernandina on the Atlantic to Cedar Key on the Gulf. In
that same year, he was re-elected to the Florida Senate. Just six weeks after the
completion of his 155.5-mile railroad track on March 1, 1861, the Civil War began.
It was at this time that David Yulee shored up his support of slavery and Florida’s
desire for secession; subsequently, he left the Senate after Florida joined the
Congress of the Confederacy.
In addition to his railroad business, David Yulee owned plantations
Margarita, a 5,100-acre sugar plantation near Homosassa Springs, and Cotton Wood
in Archer near Gainesvilleon which he employed slaves. It was on these
businesses that he concentrated his efforts during the Civil War.
After the war, David Yulee fell out of favor with Washington, and his
former letter requesting information about arms and munitions at the Chattahoochee
arsenal just prior to the war now returned to haunt him. He was tried and convicted
of treason by the government, and, after he served ten months at Ft. Pulaski,
Georgia, General Ulysses S. Grant intervened. The intercession resulted in David
Yulee’s release in 1866.
Just what was Betsey Yulee’s relationship to the successful businessman
and politician? Charles Tingley, senior research librarian at the St. Augustine
Historical Society, conducted research to find out more about Betsey Yulee, the
asylum’s first admission and her connection to the Senator. He concluded: “Yulee is
such an unusual name, being derived from Senator David Levy Yulee's mother's
maiden name. Any blacks with this surname, one must assume, are associated with
slaves owned by this prominent politician, plantation owner, and railroad owner.”
52
Out of Mind, Out of Sight
31
While no documents exist to denote her type of mental illness or why she
was sent to the prison at Chattahoochee, Betsey Yulee remained a resident of the
facility for 32 years and died of undocumented causes on July 9, 1902. Her final
resting place in the Florida State Hospital Cemetery is marked by a plaque: Plot:
div 3, cem 2, row 6, grave 4.
53
Mixing Prison and Politics
With Martin’s political ambition rising to the surface, in 1872, he was
elected to the Florida Assembly as one of Gadsden County’s representatives. As a
member of the moderate Republican “ring, he nominated Marcellus Stearns for
governor. The election placed rival Ossian Hart in the governor’s seat, and Stearns
had to settle for Lieutenant Governor. Within a few short months, Hart died and
Stearns became governor. Martin subsequently tried his bid at becoming speaker of
the Assembly. He banked on Democrats voting for him rather than putting his
opponent, a black man, in the speaker’s seat; but, the plan backfired, and Martin lost
out to radical black Republican Simon Conover. Regardless of the outcome,
Martin’s entrée into Florida politics was now solidified, a move that would serve
him well during his next bid for the same position the following year and throughout
the Republican years.
54
By 1873, rumors swirled that conditions at the prison were so intolerable
that citizens living near the convict camps were sometimes helping the prisoners
escape.
Several legislators were sent to investigate, including two black
representatives, who, according to Martin, were intent on finding signs of
mismanagement. Trying to prevent them from reaching Chattahoochee, Martin gave
the men a false departure time for a special train he had prearranged. Despite the
deception, the resourceful men found their way to Chattahoochee only to claim that
once they arrived they were marched off the grounds at bayonet point after they
discovered some prisoners chained on their backs. The Assembly failed to censure
Martin and simply called for another investigation of the prison. The session ended
before an inquiry could take place.
In March of the next year, a special investigator was sent to the prison to
assess the treatment of federal prisoners at Chattahoochee. His report noted there
were 81 prisoners at the facility with most working under guard on the prison farm.
Sally J. Ling
32
He further described housing conditions as filthy and vermin-ridden. No action was
taken, however, and questions regarding conditions at Chattahoochee subsided.
55
Martin was reelected to the Florida Assembly in 1875 and again in 1876,
but he did not regain the speaker’s seat. In addition, now that control of the
legislature was in the hands of the Democrats, things were about to change. Martin
braced himself for an attack from ruling Democrats and knew it would be only a
matter of time before his rein at the prison came to an end.
Governor George Drew recommended to the 1877 legislature that the state
prison be made self-sustaining through the leasing of prisoners. He further suggested
that the position of warden be eliminated, or at least allocated a lower salary. About
the same time, investigators were sent to the prison to make recommendations on its
operation.
The fatal blow came later that year when the legislative investigating
committee charged Martin with using prisoners for his own personal gain and
recommended that the lands surrounding the prison be rented out.
56
Records showed
that Martin used Chattahoochee inmates to build an octagonal-shaped house on his
200-acre plantation at Mt. Pleasant called “The Hermitage” and to work in his
vineyard and winery. Producing five different kinds of wine from 500-gallon wine
vats in his three-story winery, Martin was touted in conflicting reports making a
modest income to a fortune, a feat no doubt accomplished in part by his contract
with the state to provide wine for state occasions.
57
(Martin’s house, which stood for
over 100 years, was listed on the National Register of Historic Places in the 1970s. It
was subsequently razed by its owner in 1984.)
58
Martin’s rein at the Chattahoochee prison finally came to an end, but fear of
reprisal remained forefront in his mind. Believing his life in danger from those who
vehemently opposed him throughout his tenure at the prison, he left Florida and
moved north.
Prisoners Moved from State Pen to Work Camps
When the Florida Legislature turned the penitentiary at Chattahoochee into
the state’s first mental hospital, Asylum for the Indigent Insane, inmates were
transferred from state to private oversight and relocated to work camps throughout
Florida. Wearing the customary striped clothing and shackled together with heavy
chains, the prisoners were leased to businesses as physical laborers where they
Out of Mind, Out of Sight
33
worked on a plantation, the St. Johns and Lake Eustis Railroads, and a turpentine
farm.
59
As the first thirty prisoners to be relocated to the camps staggered off the
train in the northern Florida city of Live Oak, Powell, who served 14 years as
Captain of several Florida Convict Camps, was on hand to witness the roadside
procession. He described the former Chattahoochee inmates who had subsequently
been assigned to the Lake Eustace work camp:
The sun never shone upon more abject picture of misery and
dilapidation. They were gaunt, haggard, famished, wasted with
disease, smeared with grime, and clad in filthy tatters. Chains
clattered about their trembling limbs, and so inhuman was their
aspect that the crowd of curiosity seekers who had assembled
around the depot shrank back appalled.
These thirty starved and half-dying wretches were about half of the
convicts of the State of Florida. They were those who had emerged
alive from as awful an experience as men were ever fated to
undergo . . .
60
Powell went on to note that the state had rid itself of its early prisoners by
turning them over body and soul to Martin, who was paid handsomely for the
responsibility. Unrestricted by the state, prisoner abuse became routine. The backs
and legs of the inmates bore evidence of this brutality as both were scarred from
bayonet wounds. If an inmate on the line dropped from fatigue, he was “instantly
and mercilessly prodded with the cruel steel.”
61
Martin wrote in his Annual Report that the only punishment meted out to
prisoners was solitary confinement with, upon occasion, meals consisting of only
bread and water.
62
One must wonder how accurate this report was, however, and
what direct supervision Martin actually gave the inmates and guards at
Chattahoochee given the fact that serving in the legislature, overseeing the building
of his plantation, and managing his winery required considerable time away from
prison grounds. Perhaps that is why Powell recalled Martin’s discipline to be
distinctly different.
Powell noted that punishment for insubordination, escape attempts, or lack
of adequate work effort, took three forms: sweating, watering, and stringing up by
the thumbs.
63
Sweating consisted of enclosing the prisoner in a box-cell without
ventilation or light. Watering involved strapping down the prisoner and forcing a
Sally J. Ling
34
Chain gang serving at the Florida State Prison, 191? Photo courtesy of the Florida State Archives.
funnel in his mouth into which water was poured. This resulted in the distention of
the inmate’s stomach, producing unspeakable agony and a sense of imminent
death.
64
While Powell never witnessed the infliction of the first two punishments, he
did witness the physical consequences of the third, when Robert and Eugene Weaver
got off the train that day in Live Oak. It was their hands that gave them away: “They
resembled the paws of certain apes, for their thumbs, which were enormously
enlarged at the ends, were also quite as long as their index-fingers, and the tips of all
were on a line. This deformity was occasioned by stringing up, and when one stops
to consider the amount of pressure necessary to stretch out a man's thumb fully three
inches, some idea can be formed of the severity of the punishment.”
65
Escapes and Escapees
Stringing up by the thumbs paled in comparison to the guards’ plotting
certain death for other troublesome inmates. Tired of a specific prisoner’s frequent
attempts to flee, the guards learned through an informant of the prisoner’s plot to
escape through the barrack’s window after dark. All night the guards lay in wait
Out of Mind, Out of Sight
35
intending to kill the escapee. Believing something was amiss, however, the prisoner
aborted his plan; yet, that didn’t stop the guards from plotting against him one last
time. The next day, they assigned him to the blacksmith shop where they purposely
left the window open. With the lure of freedom more than the inmate could bear, he
bolted through the opened window only to be ambushed by the waiting guard.
Others escaped with equally tragic consequences. One such prisoner fled the
Lake Eustace experience by trekking 70 miles to the south into LaFayette County.
An area riddled with thick impenetrable forests intersected by wide lagoons and
palmetto flats, so monotonous was the setting that a man could wander for days and
not know whether he had made any progress at all. It was into this jungle labyrinth
filled with hungry reptiles and feral beasts that the convict soon found himself.
The tattered pieces of a stripped prison uniform were found deep in the
woods several months later. Along with the cloth remnants was a pair of prison-
issued shoes, complete with gaiter, a cloth or leather covering for the instep and
ankle. They were recognized as belonging to the escaped prisoner. When disturbed,
the rags disintegrated to reveal a pile of human bones. Powell could only suggest
that the prisoner’s death must have been dreadful.
66
While some escaped prisoners met their demise, others had successful
escapes, even if only temporary. Take for instance, the Deacon. In preparing to build
a new church in Live Oak, the Deacon’s congregation acquired all the necessary
construction materials except for those of most vital importancenails. Knowing
the lack of these necessary items was causing great distress among the congregants,
the Deacon, described as “a big, tall, and very bow-legged African,” miraculously
produced a keg of the metal spikes. With his lips sealed tight about where he had
acquired them, church members were left to wonder whether this delivery was a gift
from God.
Coincidently, Major Wise, who owned a general store in Live Oak, soon
discovered a keg of nails missing from his warehouse. Putting two and two together,
Wise summoned the law on the Deacon. The jury, refusing to believe the appearance
of the nails was due to divine intervention, sentenced the Deacon to two years at
Chattahoochee. After serving a portion of his time, the Deacon escaped.
Several years later, Wise happened to be in Eufala, Alabama, and observed
a bow-legged black man loitering around the railroad depot. Recognizing him as the
Deacon, Wise had him arrested and brought to the newly established prison camp
where the Deacon completed his sentence without further incidence.
67
Sally J. Ling
36
Inmate Deaths
Powell’s assertion that the state turned over its charges “body and soul” to
Martin, and, in essence, washed its hands of them, was substantiated by frequent
deaths. Though no records of the names of the deceased were kept, their bodies were
buried on Chattahoochee grounds. Wrapped in blankets, they were laid in a shallow
trench with dirt barely covering the remains; consequently, some of these graves
were desecrated by domestic animals.
68
A year after the prisoners disembarked at Live Oak, Dr. J.S. Hankins,
surgeon for the convicts, explained in his annual report to J.J. Dickison, adjunct
general of Florida, that many of the prisoners died during their first year after
leaving Chattahoochee and the work camp. Of the 27 prisoners reporting to the first
work camp, 19 were sick with chronic dysentery, some complicated by typhoid
fever. Two other prisoners near death eventually died and were buried within three
days of their arrival. An additional six more lived for only a short time before dying
of malaria. Still, others that seemed to recover from their dysentery were left with
such damaged bowels they died the next year.
69
Insane Occupy Asylum
With the transfer of inmates to work camps in 1877, the incarceration of
prisoners at Chattahoochee came to an end, but hundreds of citizens considered
mentally ill soon took their place. Like prisoners before them who occupied the
penitentiary for breaking the law, these new inmates were consigned to the isolated
state facility, now called the Florida Asylum for the Indigent Insane, for breaking
something elsenormal and acceptable behavior.
Out of Mind, Out of Sight
37
Chapter Photo: Pennsylvania Hospital Photo courtesy of the Library of Congress, HABS
PA,51-PHILA,394.
Chapter III
Philadelphia to Florida: The Roots of
Institutionalized Mental Health Care
In order to truly understand the history of the Florida State Hospital at
Chattahoochee and the evolution of the state’s institutionalized mental health care
system, we must first understand how America originally dealt with its insane
citizenry and trace the development of institutionalized mental health care and
psychiatry in the U.S. Only then can we put the experiences of Chattahoochee in
perspective.
From the Divine to the Personal
Under British rule during the Colonial Period (1607-1783), religious beliefs,
such as those held by Cotton Mather, an eminent Puritan minister, played a
dominant role in setting the cultural tone in America regarding the mentally ill. In
his book The Mad Among Us, Gerald Grob stated that Mather saw Satan as a
Sally J. Ling
38
tempter, someone who lured individuals into madness by exploiting their moral
weaknesses. He further explained that Mather believed sin to be at the heart of the
human condition, with madness the obvious consequence.
70
Because of Mather’s influence, to some, mental illness was considered of
divine origin with God and Satan at odds, and sincere personal confession the
antidote. With the advent of the Enlightenment (1690-1800), this viewpoint began to
change as personal responsibility for one’s actions, rather than the imposition of the
will of God, became the more dominant belief.
71
Called “distracted” or “lunatick”
72
the latter word a derivative of the
Italian word lunacus, a byproduct of the traditional link between madness and the
phases of the moon
73
the mentally ill were deemed the responsibility of families
and neighbors and were given whatever care considered appropriate to alleviate the
effects of the illness.
74
Those able to function did so amid the mainstream of life; however, many
of the severely afflicted were relegated to living in locked rooms or in small
outbuildings on the family property. Here, they would be given the necessities of
lifefood, clothing, and shelterbut little else.
Those poor souls without families, or whose families were unwilling or
unable to care for them, wandered the streets of the larger cities, not unlike our
homeless today. Treatment of these individuals consisted of confinement to jail cells
or poorhouses, facilities created by local or state governments to care for the
physically ill indigent. By contrast, the mentally ill indigent received little or no
treatment at all.
75
With the opening of the first hospital, however, formal care of the
mentally ill began.
Caring for the Mentally Ill
The roots of institutionalized mental health care can be traced back to the
mid-1700s with the opening of the nation’s first hospital, Pennsylvania Hospital in
Philadelphia, then the largest city in America. Inspired by Dr. Thomas Bond with
support from his close friend Benjamin Franklin, the hospital was established
through philanthropic means to care for Philadelphia’s impoverished physically ill.
The ability to pay was a consideration for admittance, yet the hospital did try for
balance between paying and nonpaying patients.
76
Out of Mind, Out of Sight
39
Drawing up guidelines for patient admittance in January of 1752, the
managers decided to admit all but three types of patientsthose judged incurable,
with the exception of lunatics, those suffering from smallpox, itching, or other
infections until proper departments were built, and women with young children,
unless the children were taken care of elsewhere.
77
The first two patients admitted on February 10, 1752, were Margaret
Sherlock, whom Franklin noted had “a prolepsis uteri,” and Hanna Hines, “a
lunatic.” While the hospital’s main goal was to care for the physically ill, increased
concern over mentally deranged persons wandering the streets of the growing city
prompted the inclusion of four psychiatric patients among the first six admitted.
78
In the hospital, the mentally ill were kept in cold, damp cells in the
basement where chamber pots used as toilets spewed out noxious odors. Acceptable
treatment included mild purging (cleansing of the intestinal system) and warm baths.
Patients were often restrained by the use of hand irons, leg locks, and mad-shirts
(straitjackets). To sedate violent patients, hyoscyamus (a cerebro-spinal sedative that
relieves pain and promotes sleep), camphor, and opium were administered.
Elopementsescapeswere a regular occurrence.
As if the mentally ill didn’t have enough with which to contend, their
confinement became nothing short of a curiosity. Great numbers of inquisitive
onlookers frequently visited the hospital to gawk at and converse with those
confined to the cells. Eventually, a fence with a hatch door was constructed, and
those wishing to observe the insane were required to pay four pence.
79
Treatments
With the mentally ill looked upon as wild beasts, early interventions
covered a wide range of treatments, each devised to subdue, and hopefully cure,
those with the affliction. The rationale for these early interventions, designed and
administered with all good intentions, seemed to be that since these patients were
already irrational, any treatment that would restore rationality was commendable.
80
Of course, today, we would consider these interventions to be cruel and inhumane
with little curative effect, but at the time, they were considered state-of-the-art,
supported by well thought out rationales.
Up until modern medicine, the theory prevailed that the biological basis of
physical and mental wellbeing was seated in the balance of the four humors
Sally J. Ling
40
Bloodletting booklet. Photo courtesy of the Library of Congress, LC-USZ62-95239.
(substances) that filled the body. These four substancesblack bile, yellow bile,
phlegm, and bloodwould increase or decrease based upon diet and exercise. An
excess of one type of fluid would cause an imbalance in the body, thus affecting
one’s personality or physical wellbeing.
81
Each fluid represented a specific personality characteristic. Blood was
associated with a sanguine personalitylaughter, music, and a passionate
disposition. A phlegmatic personality was sluggish and dull. Yellow bile represented
someone quick to anger or choleric (cholera meaning yellow as in yellow fever).
Lastly, black bile represented a melancholic or depressed personality, melan
meaning black.
82
Treatments varied and, for the most part, were experimental as physicians
tried to bring the humors into harmony.
Bloodletting/Transfusion
While bloodletting was rarely used in mental hospitals, it was a widely
accepted eighteenth-century cure-all. Having lost copious amounts of blood, by
having leeches placed on the skin or an incision made where blood was suctioned,
the patient would be left feeling depleted, exhausted, and noticeably anemic. For
Out of Mind, Out of Sight
41
patients diagnosed with agitated psychosis, the drop in blood pressure produced
sedation and therefore temporary relief from the agitated state. Even Dr. Benjamin
Rush (see page 49), practiced bloodletting, believing the treatment a sure cure for
almost any ailment. When newer treatments proved bloodletting archaic, he still
refused to consider it dangerous.
83
Blood transfusions, sometimes using animal blood, were also administered
in the hopes of balancing the humors.
84
Animal blood transfusions, however, proved
highly dangerous and ineffective as they compromised the individual’s immune
system causing shock and, many times, death.
Restraint
The use of chains, shackles, cuffs, straitjackets, Utica crib (an apparatus
shaped like a baby’s crib with a hinged lid on top that was fastened over the patient
at night, thereby restricting movement), and other types of restrictive devices was
prevalent during both the 18th and 19th centuries to restrain aggressive patients. In
most cases, these devices were used to prevent injury to both the patient and others,
as well as destruction of property.
85
Attendants also used the devices as punishment
for the unruly. Similarly, cold plunge baths, plunging the patient into ice water, were
also employed as a curative treatment as well as to subdue patients that were
uncontrollable.
Purging
Purging was used to balance the humors. By using an emetic, vomiting was
induced in the hopes of expelling anything that was harmful to the body.
86
Devices
Hollow Wheel The German psychiatrist, Johann Reil (1758-1813),
designed the hollow wheel to assist in the calming of patients. A patient was placed
in the interior of the wheel and could either remain stationary or move the wheel
forward or backward by walking or running. Except for visits to the restroom, it was
not unusual for a patient to spend 36 to 48 hours in the wheel. It was hoped that,
through exercise, he/she would escape his/her hallucination-filled world and return
Sally J. Ling
42
Whirling device, with patient seated in it wearing a straitjacket. Photo courtesy of the
National Library of Medicine, A013026.
to reality or be so fatigued that he/she would conform to facility protocol without
rebellion.
87
Tranquilizer chair Invented by Dr. Benjamin Rush, this apparatus
involved the patient’s arms, legs, and torso being strapped to the chair to reduce
motor activity and his or her head enclosed in a box to decrease sensory and visual
stimulation. Rush believed this would lessen the flow of blood to the brain and
produce a calming effect. The chair was also called the “sensory deprivation
chair.”
88
Twirling Devices Several twirling devices were designed to alleviate
mental illness. The first was the twirling chair in which a person spun about his own
axis. This was supposed to separate the humors, thus producing a relaxed affect. Dr.
Rush designed a variation of this known as the Gyrator. A patient was strapped to a
horizontal board and spun to stimulate blood circulation. Still another version,
O’Halloran’s swing, was developed by an Irish physician. This device rotated a
patient one hundred times a minute forcing blood to the brain with the hopes of
obtaining obedience.
89
Out of Mind, Out of Sight
43
Hydrotherapy
Hydrotherapy, or the use of water as therapeutic treatment for the body, has
been around since ancient times. Father Sebastian Kneipp, a nineteenth-century
Bavarian monk considered the Father of Hydrotherapy,” believed water could be
used to cure diseases by eliminating waste from the body and thereby balancing the
four humors, which was essential to one’s over all wellbeing. While he may not
have understood the physiological ramifications of such therapy, later research
supported his notion. Cold causes superficial blood vessels to constrict and diverts
blood to the internal organs while hot water is relaxing and causes blood vessels to
dilate, removing waste from body tissues.
90
We know hydrotherapy today as sitz
baths, saunas, whirlpools, hot tubs, and steam or Turkish baths.
In the early nineteenth-century, citizens suffering incurable physical
diseases flocked to cities such as Hot Springs, in the Appalachian Mountains of
North Carolina. Springs, with temperatures varying from 62-106 degrees Fahrenheit
and containing calcium, magnesium, sodium, sulfur, iron, Lithia or lime, were
believed to have healing powers. The Civil War brought an end to the popularity of
many of these springs when hotels surrounding them were converted to hospitals for
the wounded. Others were destroyed by fire. One warm springs resort built in 1832
near the town of Bullochville, Georgia, burned to the ground in 1865, and was later
rebuilt. The springs gained national prominence when, in 1924, President Franklin
D. Roosevelt found the resort’s warm waters therapeutic after his attack of polio. He
subsequently founded the Warm Springs Foundation to provide therapeutic
treatment for other victims of the disease.
91
While hydrotherapy as a curative treatment for the physically ill dates back
centuries, using it to help cure the mentally ill has a much shorter history and only
dates back to the 1700s when Johann Reil, the inventor of the hollow wheel,
advocated throwing patients into the sea and keeping them under water as long as
possible. He also was a proponent of tossing patients into the water while firing a
cannon. He felt that this type of terror would restore the mentally ill to their senses.
92
In 1891, Germany psychiatrist Emil Kraepelin found that demented patients
for whom no treatment was available gained great benefits from prolonged bathing.
Shortly thereafter, Alois Alzheimer introduced bath therapy at an asylum in
Frankfurt. Soon the treatment spread to America, and by 1910, hydrotherapy was
considered accepted treatment for nearly all patients, regardless of diagnosis.
Sally J. Ling
44
Prior to the introduction of the more sophisticated therapies of the 1930s,
physicians had few options when it came to calming and restricting the movements
of the severely mentally ill. This resulted in the use of restraints such as the
camisole, crib, straitjacket, hand and leg cuffs, chains, and the like. Yet, the
introduction of hydrotherapy showed promise and soon gained extensive acceptance
as the first somatic therapy to be placed into widespread use by mental health
professionals.
93
Even though the equipment was expensive, state hospitals made the
investment in order to provide the most up-to-date treatment.
Hydrotherapy treatment included hot and cold wraps, showers, needle
sprays, Scotch douches, sitz baths, and continuous baths, each type having its
specific advantage in treating different types of cases. Regardless of the type of
treatment used, Dr. L.D. Hubbard stated in his 1927 article, “Hydrotherapy in the
Mental Hospital,” that for the treatment to be of greatest benefit, it needed to be
enjoyable. He further asserted that while patients may be apprehensive at first, it was
seldom that they did not experience great pleasure and relief from hydrotherapy
once they adjusted to it.
Treatments, he explained, were not determined by chance: “Years of
research into the physiological effect of the different methods of application have
resulted in carefully prepared formulas calling for a certain number of seconds at a
certain temperature and a certain number of pounds of pressure. On the basis of
these formulas, the hospital physician prescribes hydrotherapeutic treatment with as
much care as he would prescribe drugs, and only after he is thoroughly acquainted
with the patient’s physical and mental condition.”
Hydrotherapy did not remain part of the patient’s routine from the beginning
of his illness until discharge. Treatments were discontinued when they failed to be
of benefit to the patient.
94
Considered as effective as sedatives and barbiturates as a
possible cure, hydrotherapy was used until the 1930s when shock therapies and
lobotomies took its place.
Types of Hydrotherapy
Continuous Tub Therapy
This type of hydrotherapy was used as a sedative to reduce agitated
behavior and to relieve insomnia: “Conditions of tenseness are relaxed and
Out of Mind, Out of Sight
45
restlessness relieved by the soothing action of the warm water and it is perhaps the
most immediately appreciated of all the forms of hydrotherapy.”
95
The patient lay on a canvas hammock attached to a metal frame and was
placed into a tub that had a steady flow of water at a prescribed temperature
(anywhere from 97-99 degrees). The water covered the patient to the chin and a
sheet was limply laid over the patient so he/she could rest unrestrained. Only in the
case of severely agitated patients was a covering used that prevented the patient’s
escape.
A 1930 textbook indicated that the tub bath should last from eight to 24
hours; but, in some hospitals in Germany, patients remained in continuous baths for
days or weeks at a time, sleeping and eating there. By the 1950s, however, nurses
who administered tub baths indicated that the bath should last anywhere between 15
to 45 minutes, or whatever the physician ordered.
96
Wet Sheet Wraps or Packs
This form of hydrotherapy could be of two types, either hot or cold,
depending upon the type of patient being treated and what the physician ordered.
Cold wraps were typically prescribed for agitated patients, while warm wraps were
given frail patients. Duration of the wrap was between 45 to 60 minutes.
A sheet was dipped in water from 40 to 100 degrees Fahrenheit, wrung out,
and the patient wrapped snuggly in it, similar to swaddling a baby. During this
process, nurses made sure the sheets were tucked around the extremities in such a
manner that body surfaces did not come in contact with each other. Next, two
blankets were then tucked around the patient’s neck and feet to eliminate drafts, and
a wet towel was placed across the forehead.
With the cold wrap, the first sheet acted like a stimulant to the circulatory
system, though not as severe as the cold plunge. Within minutes, a warm, soothing
glow, often inducing sleep, crept over the patient. With the warm pack, the patient
didn’t experience the tonic effect, and the result was merely sedative. Nurses
recalled that it took up to five nurses to wrap an uncooperative patient, but less than
an hour for that patient to become calm.
97
If a first wrap did not sedate the patient,
the process was repeated. Because of the amount of liquids loss during the sweating
process, fluids were frequently administered through a straw.
Sally J. Ling
46
Hydrotherapy patient sitting in a whirlpool bath. Photo courtesy of the National Library of
Medicine, A022698.
While some patients initially displayed anxiety about lying down on cold
wet sheets, former state hospital nurses stated that once the patient experienced the
treatment they often requested packs when unable to sleep, or when they got excited.
In fact, one patient unable to sleep tried to administer her own cold pack by soaking
her sheets in tap water and then rolling up on them in her bed.
98
Wet wraps proved to be a very popular therapy because they were
inexpensive, easy to administer, and had an almost immediate calming effect; but,
nurses lamented that this effect didn’t last long.
Sitz Bath
With this treatment, the patient sat in a tub up to his or her pelvis
surrounded by continuously flowing water, the temperature slightly above body
temperature. The effect, like that of continuous tub therapy, was relaxing, with a
side benefit of relieving tension and irritation in the pelvic region.
Out of Mind, Out of Sight
47
A male patient stands in a shower stall while a physical therapist gives him a heavy spray of water
aimed at his back. Photo courtesy of the National Library of Medicine, A020852.
Shower Baths and Needle Sprays
Both of these treatments involved forceful sprays of water of varying
degrees directed at the patient. In Needle Sprays, the patient would stand in a steel
box where tiny jets sprayed the patient with water under high pressure. The principal
underlying the use of this treatment was that the water striking the skin had a
positive effect on the circulation and nervous system. The belief was that the
temperature of the water, combined with the powerful spray, would assist in toning
the surface blood vessels and stimulating peripheral nerves. The dilation and
contraction of these blood vessels was believed to draw blood to the internal organs
where they would be returned to normal volume. Dr. L.D. Hubbard, a proponent of
hydrotherapy, was convinced this type of treatment had great advantage because it
Sally J. Ling
48
could be tolerated well by patients, especially those who were too feeble or ill to
undergo more drastic methods.
99
Scotch Douche
This method, which combined the effect of temperature and pressure, used a
high-pressure stream of alternating hot and cold water upon the spinal nerves. Like
the Needle Spray, this method was thought to stimulate the nerves.
Other types of douches included:
Fan Douche the spraying of water over a standing person
Jet Douche The spraying of water to a person’s back
Vapor Douche stream of vapor was applied to a small area
Pail Douche Pails of water at three different temperatures were
poured over the patient
Perineal Douche Water applied to a seated patient’s perineum (the
region of the body inferior to the pelvic diaphragm and between the legs)
100
Dry Wraps
While these are not part of hydrotherapy treatments, their purpose was to
give relief to the agitated patient sufficient enough to allow him to sleep. The patient
was wrapped from head to toe in several layers of blankets tight enough to restrict
the patient’s movement, but not so tight as to prevent him or her from turning or
getting into a comfortable position. The patient would remain in the wrapping for an
hour or more, allowing blood to be brought to the surface and for the patient to
perspire. At the conclusion of the treatment, the patient was given a shower to
balance circulation and eliminate debris deposited on the skin as a result of the
sweat.
101
Dr. L.D. Hubbard noted that patients who recovered with the help of
hydrotherapy were so appreciative of this treatment that even years after they were
discharged, they would return to the hospital and request treatments to help them
through some stressful situation.
102
Out of Mind, Out of Sight
49
Dr. Benjamin Rush. Photo courtesy of the
National Library of Medicine.
Moral Treatment and the First Freestanding Asylum
Moral treatment was introduced in the late eighteenth-century. Frenchman
Philippe Pinel began the movement and called for reformreplacing restraints and
abuse with kindness and patience, and advocating recreation. About the same time,
William Tuke, an English Quaker, rejected traditional medical intervention and
encouraged small quiet retreats where the insane could participate in “reading, light
manual labor, and conversation,” and where staff could focus on the individual
needs of its residents.
103
Thus, the small asylum tucked away from the hustle and
bustle of the city came into existence.
Virginia, a colony that had no urban center, created the first public hospital
devoted exclusively to the care and treatment of the mentally ill. Isolated in
Williamsburg, the Virginia Eastern Asylum, as it was later called, opened in 1773
with a 30-bed capacity. A keeper oversaw patients, and a traveling physician
rendered medical care.
104
At the Pennsylvania Hospital, Dr. Benjamin Rush, who was a signer of the
Declaration of Independence and had joined the hospital staff in 1783, believed
mental illness was a disease of the mind
rather than what some referred to as
“possession by demons, moonbeams,
celibacy or tobacco use.” He also believed
in moral treatment and that the mentally ill
deserved to be cared for with dignity and
receive the best available treatment. That
philosophy, coupled with the fact that the
mentally ill often came from wealthy
families who could well afford treatment
that could support hospital operations,
prompted the doctor to take on their care.
His work in revolutionizing treatment for
the mentally ill earned him the moniker,
Father of American Psychiatry.”
105
Rush put an end to the viewing of
patients as entertainment, and he introduced
occupational therapy, believing patients
would get better if they had something to do. He also did away with the use of
straitjackets and substituted his tranquilizing chair.
Sally J. Ling
50
Soon, insane patients outnumbered those with medical ailments, and it
became necessary for the hospital to build a separate asylum to confine the mentally
ill. In the winter of 1841, 100 patients were transported by carriage from the city to
their new facility, the Pennsylvania Hospital for the Insane.
The hospital, with such features as stone arches and large parlors, sat on one
hundred and one acres surrounded by woods and meadows. Patient rooms had
plenty of sun, heat, plumbing, and ventilation, more than the rooms of above
average Philadelphia homes. On the grounds, amenities included a deer park, flower
garden, railroad built for patient’s amusement, and Gentlemen’s and Ladies’
Pleasure Grounds. Overseeing the new facility as superintendent was Dr. Thomas
Story Kirkbride, who moved, along with his family, into a mansion on the
property.
106
While this was not the first freestanding psychiatric hospital in the U.S.
(there were several private psychiatric facilities), it was among the first to be
affiliated with a general hospital. Under the direction of Kirkbride, a Quaker,
kindness, not restraint, was advocated, and he encouraged recreation, exercise,
visiting the library, and participation in lectures and evening entertainment.
Moral Treatment Wanes
The second half of the nineteenth-century saw a downturn in the optimism
surrounding moral treatment due, in part, to the arrival of industrialization and the
growth of immigration into the United States. Pressures placed on mental hospitals
to admit more and more clientele soon dissolved visions of small facilities where
mentally ill people would receive individual treatment and degenerated into large
facilities where little attention was given to the individual.
107
Emerging “insane asylums” built on the outskirts of larger cities soon
became little more than the gathering of the mentally ill into isolated confinement.
Medical staff was untrained and incompetent, facilities overcrowded and
understaffed, patient abuse widespread; and in many cases, convicted criminals were
housed alongside the mentally ill.
With the founding of asylums, psychiatry emerged as a medical specialty,
the next to be recognized after surgery; yet, it must be noted that its emergence
began as a byproduct of the establishment of the asylums and not the reason for
Out of Mind, Out of Sight
51
them. This mutually dependent relationship eventually reinforced and legitimized
both psychiatric facilities and psychiatry as a profession.
108
Even with the emergence of psychiatry as a specialty, confinement of
persons to any mental hospital remained highly subjective, with husbands and
families convincing authorities of the need of commitment rather than medical
professionals using any formalized method of evaluation. This led to many being
sent away simply on a family member’s word and for a wide variety of reasons,
many of which did not have anything to do with mental illness. Such was the case
for Elizabeth T. Stone from Massachusetts, who was institutionalized from 1840-
1842.
Committed by Deception
A sullen child who was taunted unmercifully by her family, Stone
eventually left home at age 15 to work in a factory. Eight years later, she found joy
and peace when she became a follower of Jesus Christ. Stone recounted, however,
that her family was most disturbed by her newfound faith:
I now commenced a new life, and on my return home I told my
parents of it, and brothers and sisters how I had dedicated myself to
God and his Gospel, and then the vilest hatred of the family was
brought down upon me; but I was happy amidst their cruel
treatment, always rejoicing before them in the God of my salvation .
. . until my sister Nancy and brother James declared I should not go
to meeting any more. Because I had chosen the Christian
denomination to worship with, they sent for my brother, Stephen S.
Stone, to come and get me, shutting me in a room, not allowing
anyone to see me, abusing me in the most shameful manner,
because I would pray to God.
109
At Thanksgiving dinner, Stephen asked Elizabeth to go for a ride after the
meal. It was then that he had his sister committed to Charlestown McLean Asylum
in Sumerville, Massachusetts. According to Elizabeth, her brother had hired a
perfect stranger, Dr. Wheelock Graves, to sign commitment papers, even though she
had not been sick, nor had there been any sign of disease. She concluded that it was
only her faith that separated her from her family and allowed Dr. Graves to deprive
her of her liberty.
Sally J. Ling
52
In the asylum, she endured experiments that she likened to the Spanish
Inquisition.
110
These often included cold plunge-baths into ice water, wrapping her
in wet bandages for an entire day, and forcing her to take medications. When these
medications hit her system, she experienced violent convulsions and agony beyond
her ability to even describe it. The medication, which affected her brain and
autonomic nervous system, resulted in her rolling from side to side in her bed in
excruciating pain.
111
Unfortunately, Elizabeth’s fate was not an isolated case. Across America,
men, women, the elderly, and sometimes children, were sent to asylums for nothing
more than being a bother or having differing views.
Out of Mind, Out of Sight
53
Chapter photo: Dorothea Dix. Photo courtesy of the Library of Congress, LC-USZ62-9797.
Chapter IV
Florida’s Response to the Mentally Ill
The earliest record of concern for Florida’s mentally ill was found in two
Jacksonville documents from the 1830s. In the first, it was noted that a mentally ill
person could be sent to an out-of-state institution if the family had the financial
ability to support him or her.
112
In the other, the state of Florida gave newly
incorporated towns the authority to levy taxes that could be used to care for the
mentally ill;
113
but, no move was made by the legislature to care for the mentally ill
in a state facility.
By 1840, only 11 states across America had hospitals that admitted mentally
ill patients, certainly, not enough to care for their growing number. This gave rise to
the conviction that the country needed to build separate hospitals dedicated to their
Sally J. Ling
54
care. Dorothea Dix became the first advocate for the establishment of these asylums.
While she never traveled to Florida, from the 1840s through the 1860s she traveled
the Northeast and South convincing legislatures to create these institutions with their
operation funded by tax revenue.
114
Recognizing that the state of Florida lagged behind the rest of the country in
providing for its mentally ill citizenry, Attorney General D.P. Hogue suggested in
his 1850 annual report that the legislature make provisions for their care. He also
recommended sending the indigent insane to hospitals in other states where they
could receive appropriate treatment and, hopefully, a cure.
115
The Case of William Crawford
The House of Representatives voted down a resolution to provide care for
Florida’s mentally ill indigents, but the topic did not die. The case of William
Crawford of Hernando County prompted Hogue to keep his campaign alive.
Charged with “violent deeds toward other persons,” Crawford was judged violently
insane and sent to the county jail.
116
Convinced the prisoner could be better cared
for in an institution, the sheriff of Hernando County petitioned the State Legislature
for Crawford to be sent to an out-of-state facility. After ascertaining that, with the
sale of Crawford’s estate he could afford to be transported to and maintained in an
institution for a period of time, permission was granted. On March 14, 1853, Whit
Smith, appointed guardian, escorted Crawford to the South Carolina Asylum.
117
By 1854, Crawford’s estate was bankrupt. When Smith, who subsequently
paid for Crawford’s care out of his own pocket, reported this to the legislature,
Hogue recommended that he be paid $350 for serving as guardian and another
$776.62 for out-of-pocket expenses.
118
Although the Legislature did not consent to reimburse Smith for Crawford’s
expenses, it did pass an act that turned sole responsibility for Crawford’s
maintenance over to the state of Florida.
119
The Governor disagreed and vetoed the
measure on November 24, 1855.
120
Growing public concern regarding care of the
mentally ill, however, could not be squelched. The subject resurfaced in the House
of Representatives during the next session.
The House passed a bill to provide for the maintenance of Crawford, but the
Judiciary Committee in the Senate refused to consider it on the grounds that it was
unfair to other communities in the state. Nevertheless, the question of caring for the
Out of Mind, Out of Sight
55
state’s mentally ill needed to be addressed, and the committee then recommended
that the state devise a definitive plan for their care and treatment.
121
The Grand Jury of Leon County quite poignantly brought this ongoing
problem to light in a plea to Florida legislators in the Fall Term of 1856:
. . . this Grand Jury[is] urgently required to compel the County
Commissioners of the Counties to provide for the support of
Lunatics in some other way than by containing them in the county
jail, where only forty cents a day is allowed for their support, and
consequently this unfortunate class of individuals are treated in the
same manner as common criminals, there being at this time an
unfortunate man confined in our jail, who was sent there by
Gadsden County more than a year ago, and who might have been
cured had he been sent to a Lunatic Asylum where he would have
received proper treatment.
122
Following the appeal by the Grand Jury, a concerned citizen calling himself
“Humanity” suggested that the Legislature appropriate funds to place Florida’s
mentally ill in neighboring state facilities. Initiated by hearing the “piteous cries, and
heart-piercing shrieks of the poor manic who is now confined in the comfortless
tenement erected for felons,” the writer challenged the Legislature to punish the
guilty, but console the unfortunate.
123
Following these petitions, in 1856, the Florida Legislature enacted a law
charging circuit judges with the responsibility of determining the sanity of its
citizens. The individual was sent out of state if found in need of hospitalization;
124
and, if the individual was impoverished, travel, as well as room and board for the
length of his or her stay, was reimbursed from the Florida Treasury.
125
While this
measure was a step in the right direction, unfortunately it left the decision of
establishing the insanity of a person solely in the hands of the Circuit Court without
input from a medical professional.
In 1858, Governor Madison S. Perry proposed to the legislature that
$20,000 be appropriated to erect a well-appointed asylum large enough to care for
35 to 40 patients.
126
Once again, the measure died in committee. Yet, some good
came out of the session. The legislature did agree to reimburse Smith’s out-of-
pocket expenses for Crawford’s care prior to 1856,
127
and they agreed to continue to
pay maintenance to the South Carolina asylum until March 16, 1865, when he was
discharged as cured.
128
Sally J. Ling
56
Ten Floridians were patients in out-of-state asylums in Georgia and South
Carolina from 1853 to 1860.
129
With this arrangement, Florida became one of only
five states that did not have facilities to care for its mentally ill.
130
In addition to the
expenses incurred for those patients sent out of state, mentally ill citizens being
cared for by family and friends within Florida were partially, or entirely, supported
by the state. By 1876, mentally ill individuals being cared for by the state numbered
45, prompting expenses to rise to an all-time high of $13,194.68.
131
At the same
time, more mentally ill citizens were being sent to the State Penitentiary at
Chattahoochee. These individuals were confined to one room with the burden for
their care falling ultimately upon the ill-prepared guards, prison warden, and
surgeon.
After 20 years of supporting Florida’s mentally ill citizens in out-of-state
facilities, in 1877, the Florida Legislature appropriated $3,000 to convert the facility
at Chattahoochee into the Asylum for the Indigent Insane. An additional $7,000 was
earmarked for patient maintenance, support, and treatment.
132
This act became
known as the 1877 Lunacy Law. The Adjutant-General, under the direction of the
Board of Commissioners of State Institutions, was charged with supervision of the
Asylum.
133
The Chattahoochee arsenal, turned state prison, was now poised to service
Florida’s mentally ill. Here, they could be cared for in one designated facility, a
place isolated from the rest of the state’s population—out of mind, out of sight.
Out of Mind, Out of Sight
57
Chapter Photo: Postcard of the Florida State Hospital at Chattahoochee, Florida. Postmarked July
1913. Photo courtesy of Florida State Archives.
Chapter V
Transforming the Prison into an Asylum
In the wake of departing inmates from the Chattahoochee prison, many of the
buildings stood in ramshackle condition. The building for white males was
completely devoid of floor, window sash, or blinds.
134
There was no running water
or heat, except for a few wood stoves or fireplaces, and rooms contained few
amenities. Among the limited usable items were a clock, two desks, one bookcase
with prison-related volumes, several blankets, three stoves, one cooking stove, and
“some medicine of no great value.”
135
According to an interview with now deceased Dr. W.D. Rogers, former
superintendent of the Florida State Hospital, the old administration building was
renovated into the superintendent’s residence. The tower of the old arsenal was used
as part of the white male building; the barracks were repaired for use of the colored
males; and the two-story office building remained as it was.
136
Sally J. Ling
58
Above: Workers in the cane field. Below: Cane mill. Photos courtesy of the Florida State Hospital.
Out of Mind, Out of Sight
59
Dairy at the Florida State Hospital. Photo courtesy of the Florida State Hospital.
Since the prison had partially supported itself with a working farm on which
the prisoners raised livestock and produced grains and vegetables, left behind was an
assortment of farm equipment along with six mules, 12 hogs, six cattle, and one old
horse. The only provisions that remained included 370 bushels of corn and 12
barrels of corn syrup.
137
In light of the inadequate and dilapidated living quarters and
well-worn equipment, adjunct general J.J. Dickison used appropriated funds to
improve the facility. By the year’s end, upgrades included building repairs and
furnishings to the white female, white male, “colored” female, and “colored” male
departments. Adding to the upgrades were purchases of medicine, clothing,
additional livestock and farm equipment, and the stocking of provisions in the
storeroom.
In his annual report, Dickison stated that the garden farm was well
cultivated by the patients and that they were able to grow as many vegetables as they
needed. During the current year, they raised 300 bushels of Irish potatoes and 500
bushels of sweet potatoes, along with other vegetables in similar quantities. In
addition, several acres were planted in grains that produced enough oats to feed all
Sally J. Ling
60
the livestock for six months. He concluded that with additional facilities, the farm
could be made quite profitable.
138
While these repairs and upgrades were being made to the facility, Dickison
personally retrieved Florida’s mentally ill from asylums in Georgia, South Carolina,
Maryland, and Pennsylvania. When he returned in July 1877, he began hiring
suitable staff. Initial employees included a bookkeeper, cooking staff, attendants, a
night watchman, assistant physician, and a small maintenance crew.
139
Heading up
the staff was Dr. H.H. Allison, superintendent, and chief physician Dr. W.B.
Foreman. Both were medical professionals, yet neither had much experience with
the mentally ill. Still, both were committed to making the patients’ experience at
Chattahoochee as tenable as possible, as noted in Allison’s biennial report:
The grounds are thoroughly swept and cleaned every day, the
weather permitting, the houses are constantly scoured and cleaned,
the water closets [toilets] are frequently washed out and
disinfectants used to correct foul odors, and in fact every effort is
made to keep the institution clean and healthy. The patients are
warm and comfortably clad, well fed, and well provided for in every
way. We have been fortunate in securing kind and attentive
attendants, whose time, day and night, is devoted to watchful care
over our unfortunate patients.
140
Declaring One Insane
Not unlike the rest of the country, declaring someone insane was typically
based upon the observation of unusual social behavior. In Florida, citizens were
often sent to Chattahoochee by neighbors and/or authorities that identified them as
socially abnormal or simply undesirable. Included among the insane were those
afflicted with senility, epilepsy, alcoholism, homosexuality, and mental
retardation.
141
No firsthand accounts of early Florida asylum life have been uncovered, yet
experiences of patients in other state asylums can be of value in depicting their
commitment and treatment as typical of the time. Adriana P. Brickle of Philadelphia,
Pennsylvania, spent 28 years in the State Hospital for the Insane at Harrisburg,
Pennsylvania. Confined in 1857, she claimed she was declared insane and put into
the asylum for several reasons—“extravagance of spending and fondness of
Out of Mind, Out of Sight
61
dress”—and the fact that her family wanted to spare her the public disgrace of being
accused of obtaining goods under false representation.
Ultimately, her father, and a physician whom she did not know, committed
her as an alternative to putting her in jail for purchasing furniture on credit she
neglected to pay off. In the book Women of the Asylum, her father explained that
while he did not think she was insane, he claimed it was all that could be done
under the circumstances.”
142
In 1865, Tirzah F. Shedd became consigned to the Jacksonville Insane
Asylum in Illinois for an indefinite length of time by her husband on the charge of
monomania or spiritualism.
143
OthersAnna Agnew (1878-1885)
144
and Charlotte
Perkins Gilman (1877)
145
explained that their confinement was due to nervous
prostration, a condition we now know as depression, and in some cases postpartum
depression.
Gilman stated that even though she was an industrious person by nature, the
depression rendered her so weak she couldn’t even lift a knife and fork to eat:
I could not read nor write nor paint nor sew nor talk nor listen to
talking, nor anything. I lay on that lounge and wept all day. The
tears ran down into my ears on either side. I went to bed crying,
woke in the night crying, sat on the edge of the bed in the morning
and criedfrom sheer continuous pain. Not physical, the doctors
examined me and found nothing the matter. . . The baby? I nursed
her for five months. I would hold her closethat lovely child!and
instead of love and happiness, felt only pain. The tears ran down on
my breastNothing was more utterly bitter than this, that even
motherhood brought no joy.
146
No matter how or why the commitment occurred, conditions in early
asylums were, in most cases, intolerable. Such was the experience of Ada Metcalf
who spent four years (1869-1873) in a Massachusetts institution:
I have awakened in the night and found the atmosphere in our room
so rife with stench, that it was distressingly sickening and
suffocating to me. I discovered the cause to be, two or more tin
vessels, without lid or cover, filled half full, or to the brim, with
every conceivable filth, for us to inhale. And I have staggeringly
walked to a window, and for long, weary hours, pressed my face
close between the iron bars to catch a few breaths of the pure air
Sally J. Ling
62
that God has bountifully scattered throughout the length and breadth
of the landfree to allbut which I was dragged from, and
deprived of, through ignorance, bigotry, indifference, and a spirit of
tyranny and oppression that grows rank in the hearts of those under
whose dominion the helpless and unfortunate are kept subject.
147
Underfunded, Understaffed, and Inadequate Training
By December 31, 1878, Florida’s asylum at Chattahoochee had received 86
patients, who were housed in buildings according to race and gender: White
Women, White Men, Colored Women, and Colored Men. (A time of segregation,
especially in the south, separating patients on the basis of race was not unusual.) Of
these initial patients, the end-of-year report noted that 19 were discharged, 12 died,
and 55 were still in the hospital.
148
Despite facility improvements, the hiring of well-meaning personnel, and
the commitment of the superintendent and physician, the facility remained woefully
underfunded and understaffed with inadequate employee trainingproblems that
faced every asylum in the country. Unfortunately, these overwhelming challenges
often boiled over into frustration that resulted in the abusive treatment of the
patients.
In her account of time spent in the State Hospital for the Insane at
Harrisburg, Pennsylvania, Brickle noted the cruelty she witnessed at the hands of
nurses: “I saw a harmless patient who was sitting listlessly on a heating register
attacked and beaten because she would not work. One nurse knocked her down and
then called another with homicidal mania to join, and they pounded the unfortunate
creature until she was black and blue. Her brother and husband happened to call and
see her that very night, and to them some untrue story of the cause of her bruises
was given. They were not satisfied, however, and they removed her.”
149
At Chattahoochee, restraint was rigidly imposed, and with only slight
provocation, brutal force was applied. The use of straitjackets, muffs, handcuffs, and
shackles prevented violent outbursts and saved the destruction of valued clothes and
furniture. Many times, this type of restraint was used for no other reason than that
there was no one to watch the patient; but, this only led to greater distress and more
violent outbursts.
150
Perhaps some of the cruelest abuse didn’t come from the hands of attendants
at all but from the mouths of other mentally ill patients. E.B. Fleming, who was
Out of Mind, Out of Sight
63
diagnosed with melancholia (depression), spent three years in the North Texas
Hospital for the Insane in Terrell, Texas, before he escaped in 1889. In his book
Three Years in a Mad House he explained that while the asylum was generally quiet
during the day, at night, when the candles were extinguished, it became a “perfect
Babel.” He likened the dreadful howls of the dozens of maddened lunatics to
“hideous, wild and unearthly noises that joined together in a nightly demon’s
concert of which no description could do it justice.
151
Wanting a Change in the Lunacy Law
With the passing of the Lunacy Law in 1877, Florida’s Asylum for the
Indigent Insane was restricted to admitting only those individuals who were
financially destitute. Also included was a provision that allowed the option of
families, friends or relations to either send the mentally ill to the Asylum or keep
them at home and receive $150 per year from the state for their care. By the end of
1879, however, Governor George F. Drew wanted to amend two important aspects
of the law that would save the state money. The first was to discontinue the option
of allowing patient care outside the facility. He believed that if this was enacted
many patients currently receiving care would most certainly be cured once
remuneration to the families ceased. This would leave those who really needed the
care with adequate financial support from the state. The second proposal was to
allow patients into the asylum whose families were able to afford their care and
maintenance. Eventually, the state adopted both of these recommendations.
152
Upgrading the Facility
In 1881, Dr. J.H. Randolph was appointed superintendent. Over the next
several years, he and Dr. Foreman made numerous improvements to the
Chattahoochee facility. An old workshop was converted into 12 large double rooms
for the black females, and a newly built cistern supplied water to the facility. White
female patients moved into a freshly constructed 30- by 50-foot wooden building
complimented by a white picket fence. A small chapel, completely furnished
including an organ, was also added. Later, a minister was hired to conduct regularly
scheduled services.
The old three-story army barracks was renovated to include a kitchen and 56
large rooms with fresh water piped into each. Iron bars on the windows were
replaced with glass, giving the facility the look of a hospital rather than that of a
Sally J. Ling
64
Colored Women’s Ward. Photos courtesy of the Florida State Hospital.
prison. This renovation alone helped decrease the number of violent outbursts by the
white male patients who occupied the refurbished facility.
153
While these improvements were adequate, by 1884, the population of the
facility reached 157an upward trend that would afflict Chattahoochee as well as
other state institutions for the next three-quarters of a century.
In 1885, Randolph returned to private practice, and W.D. Mozely became
the superintendent. Although he was not medically trained, under his direction the
facility flourished; yet, his tenure was not without its tragedies. In his first year, 11
of 44 black patients died due to lack of ventilation in the building they occupied.
Mozely immediately upgraded the facility by making repairs to the walls and
painting the rooms. With these improvements, deaths of black males dropped to
one.
154
Also during this time, the hospital changed its name to the Florida Hospital
for the Insane.
Other improvements were made to the facility at large. Kitchens were added
to each building, stoves heated the dining room, and the water system was enhanced
Out of Mind, Out of Sight
65
with a cistern capable of meeting the demands for cooking and drinking water.
Mozely did away with crib restraints, and fired two employees for patient abuse. So
successful was his tenure that, during the year 1887-1888, there were no homicides
or suicides. Deaths by other means were reduced to zero, and recoveries increased
substantiallyan amazing accomplishment considering that at this time there were
no sophisticated treatments or psychotropic drugs.
Even with all the improvements, the facility lacked two essential
componentsa hospital to treat the physically ill and enough nurses to eliminate the
need for mechanical restraint. When the Board failed to allocate the necessary funds,
Mozely opened the asylum to the press and public during certain hours. His hope
was that the public would obtain a better understanding of the mentally ill and help
force the legislature to fund the improvements. Unfortunately, neither of these goals
was realized. There was moremuch morethat needed doing, but without the
backing of the legislature the superintendent’s hands were tied.
In 1889, Mozely’s frustration at the legislature’s turning a deaf ear to the
plight of the insane, led to his resignation. Superintendents and physicians alike
would repeat this act many times in subsequent years; yet, Gerald Grob in his book
The Mad Among Us expressed the conviction that, despite massive overcrowding
and inadequate funding, state institutions were generally committed to a therapeutic
ideal, even though reality proved quite the opposite.
155
When Superintendent Dr. J. Newton Smith arrived at Chattahoochee on
October 1, 1889, he found the system of control by restraint run riot, with patients
habitually restrained at the whim of those charged with their care.
156
The only
superintendent who, up to this time, had any experience with the mentally ill, he
issued orders that no patient be restrained without his permission. Decades followed,
however, when the use of restraint not only increased, but was applied quite
liberally.
Smith also found an ongoing and deplorable sanitation condition. Noxious
gases from an excrement dumpsite outside the asylum (excrement was carried in
buckets from the water closets, or bathrooms, to the dump site) invaded patients’
living quarters. An inadequate water supply for bathing, coupled with the fact that
many of those who were committed to the asylum by the judges were already in
moribund condition, contributed to a high mortality rate35 of the 313 residents.
Smith explained in his annual report that while the death rate was exceptionally high
for the prior six months due to these adverse conditions, one had to also take in
account that during the 12 years the facility had been occupied, the walls and floors
Sally J. Ling
66
had become saturated with “miasma and effluvia . . . against which no amount of
scrubbing, scouring, deodorizing and disinfection would avail.”
157
He concluded
that nothing short of a fire would rid the hospital of such a deplorable situation.
With cistern and water tanks empty, and the windmill only capable of
pumping a few barrels of water at any given time, the asylum desperately needed a
30- to 40-horse power engine to pump water for daily needs. Since the facility didn’t
have such an engine, Smith pulled teams of horses off the farm to haul the necessary
15 to 30 barrels of water a day. His concern for an adequate water supply intensified
when the possibility of a fire was thrown into the mix, and he believed it was only
divine mercy that had prevented this from becoming a reality.
158
Even with these setbacks, Smith was able to generate many admirable
improvements, including adding 102 beds and making the farm self-sufficient.
Despite the increase in beds, though, there were never enough, and by the end of
1892, patients numbered 350. Most were admitted for chronic mania (presence of
manic symptomseuphoric mood, hostility, aggressiveness, irritability),
159
followed
by those with dementia, acute mania, moral insanity, epileptic mania (manic
symptoms coupled with epilepsy), and simple epilepsy.
160
Of these, 188 were
Floridians with others coming from nearby states such as Georgia, South Carolina,
and North Carolina. The balance came from 12 other countries including Austria,
Cuba, England, France Spain, Germany, and Ireland.
Chief Physician Foreman retired in 1892 followed by Superintendent Smith
in 1893. The next superintendent, J.W. Trammell, was to bring continued positive
change to the institution.
Changes Enhance Living Conditions
Under Trammell, the patients built a sewage system serving the grounds and
buildings, and hot and cold water were piped into all departments, allowing the
patients to take daily baths. There was also, for the first time, an ample quantity of
medical drugs. In spite of his commitment to caring for those in his charge,
Trammell was unable to overcome the challenges in overpopulation and inadequate
funding that continued to plague the institution. This led him to implore the
legislature to appropriate $20,000 to enlarge the asylum. A persuasive man, he was
finally given approval and construction commenced.
Out of Mind, Out of Sight
67
Laundry . Photo courtesy of the Florida State Hospital.
Along with new rooms, a small laundry was erected and black patients were
assigned to the facility. Farm acreage was added, yields increased, and diets
improved. To save existing patients the trauma of watching the corpses of those who
died being carried out during the daylight, Trammell directed the staff to bury
bodies at night.
161
Burying the Dead
To the north of the hospital, 27 acres of land became the final resting place
of thousands of patients who died while in the state’s care. Known today as the
Florida State Hospital Cemetery, early patients were buried behind a locked gate
that bore no official identifying marker. Record keeping was poor in the early years
of the hospital, and unless families provided stone grave markers, gravesites were
marked with wooden plaques. After many years, those decayed leaving gravesites
mostly unmarked. Documentation improved when a new section was opened in
1932; and, over the years, the Genealogical Society has diligently documented as
many graves as its members could find.
162
Sally J. Ling
68
Mortuary. Photo courtesy of the Florida State Hospital.
Since around one third of patients who died in any given year were buried in
the adjacent cemetery, by 1976, the hospital opened its own mortuary complete with
a full-time funeral director and mortician. Families were not required to pay for
burials, but voluntary payments, in the amount of $170, were gratefully accepted.
Services, if desired, were held in a small chapel at the hospital morgue on Mondays,
Wednesdays and Fridays only, in order to accommodate the work schedule of prison
laborers.
Inmates from the River Junction state work camp, which at the time was
located on hospital grounds, dug graves, making sure two graves were always
available. As soon as one grave was filled, another was dug about a foot away. To
accommodate the many burials, the hospital maintained a carpentry shop that
fashioned coffins from medium grade pine. When completed, the coffins were lined
with white muslin and painted battleship gray. Gravestones were also produced on
hospital grounds, however due to confidentiality concerns, a number instead of a
name marked most graves.
163
Lunacy Law Contributes to Overcrowding
Improvements to the hospital were most welcomed, yet even with the
upgrades, Florida’s outdated Lunacy Law continued to dump myriad residents into
Out of Mind, Out of Sight
69
the hospital, exacerbating an already overcrowded situation. Among the committed
were those whose insanity was due to such diagnoses as pregnancy, heredity,
lightning strikes, abnormal menstruation, cigarette addiction, poverty, religion, and,
in one case, excessive masturbation.
164
Of the 230 patients admitted to the institution in 1896, many had medical
conditions unrelated to mental illness, yet were admitted when the term “insanity”
was used to deceive the jury during the commitment process. This led Trammell to
suggest to Governor William D. Bloxham that the legislature appropriate monies to
establish a separate department that would admit individuals who did not exhibit the
dangerous mental and physical predisposition typically associated with one
considered mentally ill.
165
Two unusual cases in 1896 exposed the absurdity of the existing law and
admittance procedure. In the first, a boy from Orange County was sent to
Chattahoochee despite the fact that he was in fine health except for occasional
epileptic attacks.
166
Incensed, Trammell wrote that the small boy was not the least
violent and cited the only reason he was committed was because he was dumb and
unable to defend himself in court.
167
Just a week later, an eight-year-old deaf mute, who was otherwise mentally
and physically sound, was committed to Chattahoochee. At the urging of Trammell,
adjunct general David Lang wrote the sentencing judge of the atrocity of committing
the child to a lunatic asylum. He described the patient as “fine a child as you
would find among a hundred and if taught may make a useful contribution to
society.”
168
Both children were removed, but it was their age, not their diagnosis or
the system, that kept them from an extended stay.
Though Trammel’s continued lobbying of the Legislature to revamp the
Lunacy Law did not change the basic tenants of the law, it did bring about an end to
one important aspect of it, that of allowing private parties to care for the mentally ill.
In his report to the governor, Trammel notes why changing the law was so
important:
In many cases, nurses going after lunatics reported finding the
dependent objects of their mission confined with criminals in jail
cells, with evidence of merciless care. Some lunatics are found
nude, requiring the immediate purchase of clothing; some exposed
with means of comfort and repose at night, and either injured or
sick, many are found suffering without medical attention.
169
Sally J. Ling
70
Because so many epileptics were being admitted to the asylum as part of the
Lunacy Law of 1877, Trammell recommended to the Governor that an epileptic
colony be established. Later, in 1915, the State Legislature acknowledged the need
for such an institution, but it wasn’t until 1921 that the first epileptic colony was
established at Gainesville.
170
By the end of the century, the hospital name changed to the Florida State
Hospital and now held over 600 patients. While the physical facility continued to be
upgraded, adequate medical and psychological care lagged far behind. Patients were
still being restrained, and rumors of mistreatment began to leak to the publica
firestorm that had been brewing on the horizon for years.
Out of Mind, Out of Sight
71
Chapter Photo: Lab. Photo courtesy of the Florida State Hospital.
Chapter VI
Entering the 20th Century
Scandal Rocks the Institution
When Trammell retired in 1901, Dr. V.H. Gwynn succeeded him. A general
practitioner who believed amateur operas, patient dances, and religious services
would relieve patients of their mental illnesses and bring about an improved
condition,
171
his first few years remained quiet. That was soon to change.
In 1904, rumors implicated Gwynn in a scheme to coerce hospital
employees to vote for gubernatorial candidate Napoleon Bonaparte Broward of
Jacksonville. To avert a scandal once he took office, Governor Broward removed
Gwynn and replaced him with B.F. Whitner, a former legislator.
172
Upon his arrival
at Chattahoochee, Whitner was appalled to find the facility in such deplorable
condition, and subsequently implored his former legislative colleagues to launch a
full investigation. The inquiry, conducted by a six-man investigative joint
committee, took a year to conclude and absolved the Whitner administration of any
Sally J. Ling
72
wrongdoing, and placed the blame squarely on the shoulders of Gwynn’s
administration.
The committee revealed many evils in the May 17, 1905 investigation, yet
the hyperbole of the report suggested the inquiry was based more on a grudge
against the previous administration and the Board of State Institutions.
173
The
Florida State News headlined its coverage of the report in an article entitled
“Asylum Report is Sensational” and included excerpts for their readers. Outlined in
the selections were the type of patients who were dumped into the asylum without
being indigent or insane—“little children, young men and young women, middle-
aged men and women, old, feeble and decrepit men and women afflicted with all
sorts of mental and physical ailments. These people, the report suggested, should
be at home with parents or relatives, in the county poorhouses or infirmaries, or free
to earn their own living.
The article went on to state that evidence presented confirmed that, in some
instances, management had been cruel, negligent, and heartless. It also accused
attendants and nurses of being drunk while on duty and brutally and inhumanly cruel
to the helpless. The suggestion that the very institution had been infiltrated by “vice
and immorality to the extent that even inmates have begged and pleaded to be
released on account of it,” left citizens living nearby feeling outraged.
174
Some of the incidents noted in the report included widespread use of bodily
restraints,
175
severe whipping, choking, hitting, slapping, and stomping.
176
Under-
aged patients were reportedly found beaten and barely clothed,
177
and a white patient
Eugene Davis allegedly died as the result of a beating. The committee charged with
the investigation questioned Dr. Christie, a physician at the facility from July 1904
through March 1905, regarding Davis’ death. Christie confessed that he had seen
patients bruised with streaks across their faces and that other attendants admitted
seeing the abuse as well. He also recounted that patients told him the assaults were
committed by the attendants.
Asked whether he had treated a patient who had been inflicted with cruel
treatment, Christie cited the case of Eugene Davis from Live Oak, Florida, who had
been severely whipped. According to Christie, Davis had remained in “bad shape”
for four or five days but was ultimately put in the hospital where he eventually died.
Asked if Davis had died of his injuries, Christie replied that Davis had stayed in the
hospital a little longer than a month, but he stopped shy of admitting that injuries
from the whipping had killed him.
178
Out of Mind, Out of Sight
73
Men’s Ward. Photo courtesy of the Florida State Hospital.
Christie acknowledged that several other incidents of severe beatings had
occurred and that Mrs. Mercer, a patient, had told him she had been severely
punished by four attendants who held her down and stuffed an apron in her mouth.
Though Christie avowed he reported the incidents to Superintendent Gwynn, he said
most of the staff had been retained.
179
In addition to investigating the physical cruelty inflicted on the patients,
interviews conducted with the nurses disclosed that aside from their on-the-job
training, most of them had little medical to no psychiatric instruction.
180
The report
also accused some of the staff of being addicted to morphine.
The committee made a thorough site inspection of the facility. Their
findings indicated that the powerhouse, laundry, kitchen and cooking department,
and dairy to be quite suitable,
181
but upon inspection of the White Male Wards 1, 2,
and 3, which were part of the old arsenal, the committee found that the interiors
were in deplorable condition. Debris from Ward 2 dropped onto the wooden floor in
Ward 1 filling the seams with poisonous filth that emitted foul orders and caused
the floor to rot. So unsanitary was this condition that the committee noted it was
“cruel and inhuman to compel even human beings totally oblivious to their
surroundings to live and stay in it.”
182
Their recommendation was to replace the
wooden structure with one built of brick and mortar.
Sally J. Ling
74
The committee further noted a serious condition that had plagued the
institution since its inceptionno systematic or scientific system of treatment for
the restoration of the mind.
183
Other areas of concern were noted, but the committee
admitted these problems were not the hospital’s fault and instead planted the blame
directly on the Legislature that had failed to appropriate necessary funds for
improvements.
Once the report was made public, press across the state had a field day. The
St. Augustine Record recommended that the Legislature act immediately with a
thorough housecleaning to remove the “blight that is worse than death. The
Pensacola Journal referred to the situation as “a chapter of high crime unparalleled
in the history of this or any other State,” and called for an investigation in which no
guilty man should escape. And the Fort Pierce News suggested that the guilty
should be punished to the fullest extent of the law even if it meant the investigation
would reach “crowned heads.”
184
Nurses, who found themselves depicted in a most offensive way by the
investigative committee, sent a telegram to the Speaker complaining that their
character was besmudged by the committee’s report.
185
Members of the House of
Representatives vigorously debated the merits of the investigation, yet the document
was ultimately accepted by a vote of 52 to 10.
Following the report, several newspapers called for a full investigation of
the institution, suggesting that politics had played a large part in initiating the
investigation and in trying to cover up the committee’s report. One paper accused
Governor Broward and his Board of State Institution of denying all charges made
against the asylum management,
186
while another accused Speaker General Gilcrist
of shielding from investigation and punishment those responsible for a large part of
the crookedness at the hospital.
187
Both papers indicated the lack of action by the
legislature was due to upcoming reelection bids.
Scandal Brings Changes
While politics may have been the catalyst for the investigation, the scandal
finally brought to light the plight of the State’s forgotten insane; but, since the
legislature met only every other year, it wasn’t until 1907 that monies were
appropriated to expand the hospital facility. Whitner added a new laboratory and
operating room and purchased an ice plant.
188
These improvements were minor
Out of Mind, Out of Sight
75
compared to the hospitals ongoing and more pressing issues that remained
consistently ignoredgross overcrowding and understaffing.
Acquiring and retaining qualified attendants remained a constant challenge.
Because of competing medical facilities where wages were higher coupled with the
inaccessibility of Chattahoochee and its lack of recreation or amusements, workers
were reluctant to relocate. To counter these obstacles and attract workers to the
hospital, Whitner increased salaries.
189
With only two physicians on staff, in a 1910 report Whitner stated what he
believed: by the end of 1911, the population of the institution would be over
1,000.
190
Records show he wasn’t far off. Patient count numbered 929 at the end of
1910, and 1,107 at the end of 1912.
To extend more humane medical care to those in need, patients were no
longer secluded in small rooms, and the crib,
191
straitjackets, and camisoles were
eliminated.
192
Another physician was added to the permanent staff, and over the next
several years, Whitner hired five additional interns and four visiting doctors to serve
at various times throughout the year. Not paid any salary, the visiting doctors were
only reimbursed for traveling expenses, a sum far less than what they would make in
private practice.
The number of permanent physicians still wasn’t ideal, yet it proved quite
adequate when, in 1911, a black female patient came down with a mild case of small
pox. Quick action by the medical team to confine her to a separate ward averted a
deadly epidemic.
In 1912, the operating room was outfitted with new surgical instruments and
sterilizers, and six visiting doctors made regular visits. Unfortunately, the four-
month interval with which the doctors visited coupled with the increase of
patients1,366 in 1914was little help to the three full time physicians who
remained on call day and night.
193
There was some good news, however. For the
first time, the hospital employed a full-time resident dentist, Dr. J.G. Wilson.
194
Whitner resigned in March of 1913, and W.W. Trammell succeeded him.
195
From 1914-1916, few physical improvements were made to the hospital despite the
superintendent’s repeated requests. The high price of labor during World War I may
have been the cause;
196
yet, great strides were made during the next six years with
the construction of two new hospitalsa receiving hospital and a tuberculosis
hospital.
Sally J. Ling
76
Class of 1923: Dora Fulgham, Eula McDonald, Wilma Ramsey, Martha Lightsey and Natalie
Ramsey.. Photo courtesy of the Florida State Hospital.
As was typical of the times, the facilities remained segregated. Black
patients were restricted from entering the receiving hospital and similarly were not
allowed in the white operating room. Instead, the supervisor’s office served as their
operating room, with instruments for operations owned by the physician. This
inconvenience paled in comparison, however, to the bigger problem facing
physiciansno case histories. Without them, it was extremely difficult to properly
diagnose or treat patients. Clerical help would have alleviated the problem, but the
Board refused to approve such expenditure.
Adding to the hospital’s woes was the appalling manner in which garbage
was removed and dumped. Flies infested the garbage pile and eventually spread
throughout hospital grounds, causing both an annoyance and extremely unsanitary
conditions. Exacerbating the problem was the lack of cleanliness on the farm and the
fact that most of the equipment failed to function properly. The equipment was so
dilapidated it presented a major health hazard, yet no funds existed to rectify either
situation.
197
Out of Mind, Out of Sight
77
Occupational Therapy Room. Photo courtesy of the Florida State Hospital.
Improvements Made
On the bright side, several significant improvements were made. The first
was the opening of a nurse’s training school in 1919.
198
Under the supervision of
Miss Pearl Summerford, three female students made substantial contributions to the
institution during their training, and upon graduation in 1921, they stayed on at the
hospital.
199
For decades to come, the nursing school would play a major role in
providing trained professionals to the institution.
Music became part of the patient’s therapy and with the inclusion of an
electric piano, four phonographs, singing, movies, and dances, the patients were
easily distracted from their depressed states.
200
Contributing to the overall success
of Trammel’s tenure was the Red Cross and Women’s Clubs, who found placements
for borderline cases. This resulted in a record number of patient discharges.
The physical plant was improved with the addition of a new kitchen, and the
building of a power plant allowed for the purchase of the single most enhancement
to the medical facilityan X-ray machine purchased from surplus World War I
equipment. Now, for the first time, doctors could thoroughly examine each patient.
While improvements to the facilities continued, no consideration was given
to increasing the medical staff that, by this time, cared for patients at a ratio of one
Sally J. Ling
78
doctor to every 400 patients. Hoping to improve this situation, the medical staff
pressured the Board to create the position of clinical director, a position that
garnered much more respect, even though duties were comparable to that of the
chief physician. Dr. W.H. Spiers, an assistant physician on staff, was the first to be
appointed to this position.
201
Decade Sees Substantial Improvements
During the 1920s, the hospital experienced amazing growth. With support
from the Board of Commissioners of State Institutions and Governors Cary A.
Hardee (1923-1924) and John W. Martin (1925-1926), Superintendent William V.
Knott (who later became State Treasurer) and the new clinical director Dr. Folmar,
saw to it that the needs of the hospital were met. The receiving hospital was fully
equipped and a 150-bed annex constructed. For the first time, black patients were
admitted to the receiving hospital and all patients were weighed, bathed, and given a
thorough examination. Old buildings were renovated with new bathrooms and
showers, and 70 telephones were installed throughout the complex.
202
The erection of a 250,000-gallon water tank allowed for the installation of
water fountains in the yard of every ward. This resulted in completely eliminating
communicable mouth diseases that in previous years were spread by patients
drinking from communal cups. Classes in needlework, gardening, and basket
weaving bolstered those in occupational therapy, and recreation was expanded to
include dances every Friday night with employees acting as partners for the patients.
From Custodial Care to Curative Treatment
With 10 physicianssix full time residents and four visiting physicians
coupled with the graduation of 24 nurses from the nursing school, by the end of the
decade the hospital began its transition from custodial care (simply monitoring the
patients) to curative care (actually providing proven treatment). Unfortunately, an
influenza epidemic riddled the hospital in the spring of 1926, killing 413 out of the
3,843 patients; yet, despite this, a discharge rate of 51 percent was the highest in the
hospital’s history
203
quite a feat considering the patient population exceeded
capacity by 800.
204
Out of Mind, Out of Sight
79
Case Histories
Several case histories from the late 1920s give an example of the type of
individuals that were admitted to the Florida State Hospital at Chattahoochee. While
some of the descriptions are sketchy, they do give a colorful picture of the era and
the culture that surrounded admissions to the hospital.
Ferris Todd
(Admitted: 8/3/1928 Discharged: 11/3/1928)
Ferris Todd was an indigent 21-year-old white male laborer from the
northern Florida town of Sopchoppy, in Wakulla County. Notes reveal he held
several jobspoultry worker, butcher, and laborer on the railroad. He had never
been a mental patient, and there was no insanity or epilepsy in the family history,
although an uncle did commit suicide. While his father’s relatives were heavy
drinkers, no drug addicts were found in the immediate family.
His family committed him to Chattahoochee because they felt this was a
better alternative than his being returned to the state penitentiary at Raiford where he
had previously served 31 months for killing a man in self-defense. Sent up for 20
years, a conditional pardon secured his release.
Upon examination, it was noted that Todd sat quietly in his chair, answered
questions in coherent fashion, was tidy, cooperative, insightful, and showed good
judgment. He stated that, after he was released from Raiford, he drank occasionally,
and on one occasion while intoxicated, he got into a car that he thought was his. He
claimed the car was the same make and model as his own and was parked beside it.
As soon as he discovered his mistake, he returned the car to its owner. Later, he was
arrested and tried for theft. This incident was the only reason he could think of for
sending him to Chattahoochee, except that he drank up to that time. After that
incident, he gave up drinking and believed there was nothing wrong with his mind.
The Examining Board found no psychosis, yet Todd was not discharged.
Instead, he was transferred to General Wards at Chattahoochee. On October 22,
1928, he escaped from Ward 5 and was returned the same night. He was discharged
less than a month later.
205
Sally J. Ling
80
Death certificate of Peter Christofoli. Photo courtesy of the Florida State Hospital.
Peter Christofoli
(Admitted 8/25/1915 Died 8/30/1929)
From Duval County, Peter Christofoli, age 29, entered Chattahoochee on
August 25, 1915. An Italian epileptic who spoke no English, he entered the facility
with a diagnosis of Epileptic Insanity. Records from his file indicate that the only
physical injuries he sustained while at the facility were an infected foot, which was
eventually cured, and a fractured nasal septum that resulted from a fall during a
seizure.
Christofoli’s record includes a partial Convulsion Report tracking his
epileptic convulsions from October 10, 1917, through September 30, 1929. It
indicates that he had convulsions on an average of four and one half days per month,
with seven convulsions in August 1929. The last convulsion occurred on August 30,
1929, resulting in his death at 3:20 p.m. He was 43. The direct cause of death is
listed as Staticus Epilepticus, epilepsy with mental deterioration.
Out of Mind, Out of Sight
81
Upon his death the hospital gave Mrs. Louise Christofoli the choice of
having the body shipped back to Tampa for a fee of $47, which included embalming
and transportation. A casket and robe would cost an additional $55 to $95,
depending on the quality and color of the casket, grey or black. Unable to afford
these charges, John Christofoli requested that his son be buried on hospital grounds.
A note in the file indicates the body was buried in the Hospital Cemetery on
September 3, 1929.
206
Benjamin Alva Mendoza
(Admitted 1925, Died 1941)
Another epileptic, Benjamin Alva Mendoza, a product of the country’s
itinerant farmer landscape, was consigned to the Florida State Hospital as an older
teen. The second child of Charles Mendoza Sr. and Virginia Torres Mendoza,
Mexican immigrants, Benjamin was born on July 23, 1907, in Bridgeport, Texas,
and was the eldest son of what would eventually be 13 children. His father worked
the cotton fields of Texas and beet fields of Wyoming before moving the family to
Tampa, Florida, in the early 1920s. Tony Mendoza, Benjamin’s youngest brother,
recalled that: The family was very poor, sometimes on welfare, but always hard-
working. Charles worked as a pipefitter helper for the gas company, and all the kids
that could work, did as much as they could.”
While it is unknown when Benjamin had his first seizure or its severity, in
1925, at the tender age of eighteen, he was sent to the hospital at Chattahoochee for
custodial care. Tony believed it was unlikely that the family ever saw Benjamin
again since Chattahoochee was a long way from Tampa, the family was very poor,
and the economy was depressed.
Sadly, Benjamin contracted TB while at the hospital and died on August 31,
1941. Buried in the hospital cemetery, his grave was lost to the family until the
early 1980s when, with the help of hospital officials, they were finally able to locate
the gravesite. Later, the family had a proper headstone installed and returned to
place flowers on Benjamin’s grave.
207
Sally J. Ling
82
Death certificate of Benjamin Mendoza. Photo courtesy of Rebehak Mendoza.
Out of Mind, Out of Sight
83
Chapter Photo: Shock treatment room. Photo courtesy of the Florida State Hospital.
Chapter VII
New Therapies Stir Hope and Skepticism
Legislative indifference marked the hospital during the early years of the 1930s; but
in 1934, when Preston Ayers became superintendent and Dr. J.H. Pound was
appointed clinical director, things began to change. At the time, 17 doctors, 60
nurses, and 220 attendants treated a record breaking 3,740 patients with the doctor to
patient ratio reaching one to 588 compared to other states at one to 226. In fact, the
overcrowding at the hospital became so critical that, in 1935, new patients were
refused altogether with the exception of the most violent who had to be approved by
a unanimous vote of the Board.
208
This prompted Ayers and Pound to undertake a
complete overhaul of the institution.
209
Over the next several years, six new
departments were added with Occupational Therapy, Horticulture, and Recreation
being among the first.
Unlike today’s Occupational Therapy profession that deals with acts of
daily living and rehabilitation of fine motor coordination, the hospital’s
Sally J. Ling
84
Occupational Therapy Department helped organize and direct employment for those
patients who were able to work. Utilizing patient manpower, the hospital reduced
outside labor costs and provided essential job training for those anticipating future
release. The Horticultural Department, responsible for landscaping and maintaining
the grounds, employed many of these patients.
210
The Recreation Department,
considered on par with occupational therapy in channeling patient energies,
introduced new activities such as baseball games, picnics, concerts, and card
games.
211
In February 1935, the Department of Corrections established a prison camp
on hospital grounds. Fifty-seven white and 44 black prisoners, in separate camps,
paid their penance by working the hospital farm. The two camps operated according
to the rules of the State Prison Commission under the direction of the
Superintendent of the hospital. The white prisoners were mostly young boys ranging
in age from 16 to 22, many first time offenders. With the aim of the camp to
rehabilitate these young men, they did not wear the customary stripped prison
uniforms, nor did they adhere to stringent rules. Instead, they were provided a
variety of recreational opportunities and granted privileges not ordinarily extended
to state prisoners.
212
Other departments were added later at Chattahoochee, including the
Sanitary and Peace Department that served three main purposes: eradication of all
unsanitary conditions, maintenance and order, and protection of state property. The
responsibilities of this department were far more reaching, however. Assisting in the
capture of escaped prisoners from the hospital prison camp, the department logged
over 11,000 pursuit miles. In addition, the department manned the 24-hour
information booth at the entrance to the hospital and guarded the 1,300-acre wild
game preserve from fire and theft.
213
214
For all practical purposes, the nine officers
in this department acted as guards whose main function was protecting “life, liberty,
and property of the Florida State Hospital . . .”
215
Prior to the establishment of the Extermination Department, in February
1936, all the ward buildings, as well as many other structures on the campus,
experienced a severe infestation of roaches, mice, ants, bed bugs, fleas, water bugs,
moths, and rats. So severe was this problem that at night rats regularly ran across the
beds in the wards and hospital buildings and bit the patients. Organized to eradicate
all infestations of rodents and other pesky insects, this department proved invaluable
when, by the end of their initial program, 5,000 rats, over 1,000 mice, and more than
three barrels of roaches and water bugs were expunged from the hospital.
216
Out of Mind, Out of Sight
85
Aerial view of the Florida State Hospital 1930s. Photo courtesy of the Florida State Hospital.
Along with the introduction of the previously mentioned departments, four
new buildings were added to the complex, including a tuberculosis hospital, partially
funded by the federal Public Works Administration.
217
With the hospital facilities
housing 952 patients over capacity, it was hoped that the allocated 966 additional
beds would alleviate the overcrowding.
218
Unfortunately, funding to equip the
buildings was not appropriated, and occupation was postponed.
While this delay was most disappointing, a major innovation occurred in the
White Female Departmentthe installation and operation of a beauty parlor.
Operated by a certified beautician, six patients, who acted as assistants, received
daily instruction, and patients capable of taking care of themselves were given a
powder puff, powder, and rouge. The Superintendent’s report noted that the beauty
parlor provided invaluable service by instilling pride in the women’s personal
appearance and increasing their morale.
219
Sally J. Ling
86
The asylum employed over 800 workers by 1936. As most were support
staff, this left the doctor/patient ratio acutely high and the facilitation of normal
everyday rounds a challenge. Similar challenges faced other departments, including
the kitchens where 13,080 meals a day were served to over 4,000 patients.
220
Knowing how important proper nutrition was to patient recovery, Ayers insisted
diets be balanced with the proper amounts of fruits, vegetables, meats, fish, eggs,
and cereals.
221
He also knew that the hospital could not run effectively without proper
accountability and, therefore, instituted weekly department reports, something that
up to that time was not required. One of these reports came from the Chief
Physician, who recommended passing a startling new Eugenics Lawone that
would allow for the sterilization of insane patients. His contention was that the
measure would eliminate, to a certain extent, the real source of supply of insanity
since, in his mind, insanity would continue to increase so long as persons unfit to
procreate were allowed to do so.
222
The suggestion was dismissed.
Inspection and Survey Uncovers Strengths and Deficiencies
It is unknown what specific incident or circumstance prompted an
inspection and survey to be conducted at the Florida State Hospital at
Chattahoochee; however, sometime in the mid-1930s, Dr. Marynia Farnhan was
asked to offer recommendations for improvement to the hospital and to evaluate the
number of patients who might be discharged.
223
Discoveries included:
Severe lack of privacy - communal showers, just feet from the
washbasins and toilets, some with no seats, forced patients to bathe
while others used the facility.
Toddler found - a normal male child of three was found living in a
white female ward among the acutely physically ill and several
intensely violent and disturbed patients. The mother, who was
pregnant at the time she was brought to the hospital for treatment by
the father, was taking care of the child since locating the father was
unsuccessful. According to the hospital, the toddler was there only
after every effort was made to place him elsewhere, and the child’s
county of resident had refused to take responsibility
Out of Mind, Out of Sight
87
Colored Men’s Ward bathroom. Photo courtesy of the Florida State Archives.
Restraint - use of leather cuffs, as well as chains, was widespread
due to so few attendants.
Food - meals were found to have excessive use of starches and
syrup while being almost devoid of fresh fruits. One menu cited
included beef stew, Irish potatoes, grits, macaroni, light bread, and
syrup.
Physician to patient ratio was “clearly ridiculous,” and Farnhan
blamed this for the fact that many patients could not be seen for
years at a time.
A condensed version of her report (found in the Appendix with a complete
version online) offers an unprecedented look at the Case History of the physical
facility, hospital operations, and the conditions both patients and staff experienced
during this time in the institution’s history.
Sally J. Ling
88
Hospital Initiates New System
By the late 1930s, a system was in place that would better record patient
information. One of the earliest documented, and most unusual case histories, was
that of Percy A. Graham.
Percy A. Graham
(Admitted - May 1938, Died - October 1938)
On April 29, 1938, county judge C.M. Wiggins of Bartow, Florida, sent an
urgent letter to the Board of Commissioners of State Institutions regarding Percy A.
Graham, 46:
No insanity was apparent until tooth was extracted five weeks ago.
The next day he developed 105 degrees of fever and rapidly
developed insanity . . . Started singing, whistling and laughing.
Soon became moody, angry and threatening. Turned against his
wife centered love in 16-year-old daughter. Last Sunday near
midnight made murderous attack on wife and attempted rape of
daughter who interfered and beat down aged relative who came to
rescue . . . Now restrained in special part of hospital with two men
guards. Thinks he is Jesus Christ and the doctor is the devil. He is
violently afraid of everyone, and, thinking they wish to kill him, he
attacked first . . . VERY ANXIOUS TO SEND HIM TO STATE
HOSPITAL AT EARLIEST POSSIBLE MOMENT.
224
Lakeland physicians John J. Wilson and Edgar Watson signed papers on
May 2, 1938,
225
sending Percy, who was considered very dangerous and needed to
be confined, to the Florida State Hospital. He was admitted on May 4, 1938, with
the tentative diagnosis of Paranoia with homicidal tendencies.
226
A detailed family history was obtained from Percy’s wife Lena in which
she noted that after Graham’s tooth extraction he’d suffered a heart attack.
Subsequent to that, Percy had described the experience as something that had “burst
or exploded . . . similar to the report of a rifle, or the pricking of a balloon, inside his
body.” She also told doctors that Graham’s mother had committed suicide by gas
and felt the malady inherited. While she was optimistic about his outcome, she
expressed genuine concern and was anxious to know if he could ever return home.
227
Out of Mind, Out of Sight
89
Doctors gave Percy a follow up evaluation on August 18. He was found to
be acutely excited and disturbed with apparently no change since his admittance. His
diagnosis was manic depressive psychosis with a poor prognosis.
228
During his
hospital stay, letters regarding Percy’s condition were exchanged frequently
between Dr. Stevens and the family as well as with Dr. Wilson, the family
physician. In them, Stevens pointed out that Percy was still very much disturbed,
restless, over-talkative, expressed some grandiose ideas, and reacted to
hallucinations.
229
On October 22, a Western Union telegram arrived at Lena Graham’s home
informing her that Percy had passed away quite suddenly at 5:30 a.m. that
morning.
230
No reason for his unexpected death was given; however, a subsequent
letter indicates that it was Dr. Stevens’ belief he died from “absorption of poison
from his low grade infection and continuous brain excitement.”
231
Unlike many of the patients who died at Chattahoochee and were buried just
outside hospital grounds, Percy was transported by hearse back to Lakeland for a
family burial.
232
New Therapies Stir Hope and Skepticism
In the 1930s, the hospital underwent tremendous physical and
organizational changes; but, the most startling change did not come about by the
hiring of more staff, the building of more wards, or changes in the hospital’s
operating procedures. Instead, it came about by the introduction of new innovative
treatmentsfever, insulin, metrazol, and shock therapies, as well as lobotomy
treatments that would profoundly impact those who were institutionalized. With the
introduction of these new treatments, the possible recovery of tens of thousands of
severely and chronically mentally ill patients was now within reach.
233
Fever Therapy
Trained at the University of Vienna, Julius Wagner-Jauregg noticed that
symptoms of mental illness occasionally disappeared in patients with typhoid fever.
To further study this phenomenon, he obtained blood infected with malaria and
inoculated several soldiers who were diagnosed with psychoses. Of the eight
administered this treatment, four showed complete remission while two others
improved.
Sally J. Ling
90
Florida State Hospital Physicians Back Row: W.H. Spiers, W.M. Bevis, A.E. Couter; Front
Row: H.M.Smith , man on right unidentified. Photo courtesy of the Florida State Hospital.
Holding much promise for the recovery of paretic (a condition typified by
partial loss of movement) and psychotic patients, Wagner-Jauregg’s work garnered
him the Nobel Prize in 1927. So popular was this therapy, it quickly spread to the
U.S. Subsequent use by physicians, however, resulted in less than stellar results, and
a 1939 article by Oskar Diethelm condemned the “enthusiasm for novel but untested
therapies.”
234
Out of Mind, Out of Sight
91
Insulin Shock Therapy
Viennese physician Manfred Sakel introduced insulin shock treatment in the
mid-1930s. Having observed mental changes in diabetic drug addicts treated with
insulin, he used the technique on psychotic patients, specifically schizophrenics. The
injection of insulin lowered the sugar in the blood resulting in a hypoglycemic state
of “shock.” While in shock, the patient fell into a deep coma that was relieved by the
administration of sugar. Sakel claimed that the procedure was highly effective in the
treatment of mental illnesses.
235
Since insulin therapy was decidedly controversial for its experimental
nature, some physicians were reluctant to jump on the insulin therapy bandwagon.
One physician challenged this treatment in a letter to a colleague: “I have a
suspicion that some of these schizophrenic patients get well with insulin shock
treatment and other similar methods that are exceedingly painful and disagreeable in
order to get out of the sanitarium where they use such methods, or at least to escape
their repetition.”
236
Others expressed more openness to the procedure that could potentially help
thousands, especially at a time when state hospitals were overwhelmed with
patients, a high number of which had no hope of recovery.
At the Florida State Hospital, Dr. A.L. Huskey found mixed results when he
used insulin shock therapy on a number of schizophrenic patients. Each male patient
was physically healthy, under 30 years of age, and had been afflicted with mental
illness from two months to seven years. With one physician and one attendant
treating six patients at a time, each patient was given an intramuscular injection of
insulin at 7:30 a.m. on a fasting stomach. This was repeated over a series of days
until a “shock dosage” was reached (patient went into a coma). After that, the
patient was shocked daily, except on Sundays.
Huskey noted that the most difficult part of this type of therapy was
controlling the depth and length of each coma. It was generally believed that the best
method was to take the very depressed patients to a highly excitable stage and then
stop the treatment. In hyperactive patients, a deep coma was induced for some time
before interruption. There was, however, no definite rule, and it was only through
close and careful observation of each individual patient that the desirable depth of
coma was determined.
237
Of the 15 cases covered in Huskey’s report, five were greatly improved
(showed no psychotic residuals), three were moderately improved (patients had
Sally J. Ling
92
some psychotic residuals but were able to make a social recovery), five were slightly
improved (patients retained most of their psychotic trends but were able to repress
them somewhat), and two were unimproved.
While no patients died during these treatments, one did sustain a fracture-
dislocation of the shoulder joint due to muscular violence during the procedure, and
one patient went into an extended coma for 30 hours.
238
Every patient, however, was
furloughed from the institution with guardians given explicit instructions on how to
care for them.
Metrazol Shock Therapy
At the same time insulin shock therapy was taking hold, Hungarian
physician Ladislas von Meduna introduced pentilenetetrazol, also known as
Metrazol. When given intravenously in large doses, the synthetic cardiac and
respiratory stimulant caused quick and violent convulsions. Despite the dramatic
physical effects of the treatment, von Meduna reported a discharge rate of 50
percent and even dramatic cures after he treated 110 mental patients.
Dr. M.E. Sabitini noted in his paper “The History of Shock Therapy in
Psychiatry” that there were distinct differences between insulin and Metrazol shock
therapies. First, while insulin coma required five to nine hours of hospitalization and
close follow-up, it was easily controlled and stopped with injections of glucose or
adrenalin, when needed; Metrazol, on the other hand, was stronger and more
difficult to control. Second, insulin therapy caused few side effects while Metrazol
convulsions were so severe that they caused spine fractures in 42 percent of the
patients. Third, and the only down side, insulin was more expensive and less reliable
than Metrozol in inducing convulsions.
239
Dr. Huskey administered Metrazol therapy to a few patients at the Florida
State Hospital, but it did not prove as promising as treatment with insulin; still, he
remained optimistic, believing that improvements in the technique would prove
comparable with insulin shock therapy because it had the advantage of requiring
much less time for administration and a less experienced staff.
240
With all its promise, Metrazol shock therapy proved to be short lived; and,
with the advent of electroconvulsive therapy (ECT), was slowly phased out. It
disappeared completely by the late 1940s.
Out of Mind, Out of Sight
93
Electroconvulsive Therapy (ECT)
Italian physician Ugo Cerletti believed Metrazol shock therapy was useful
in the treatment of schizophrenia; but, unlike insulin therapy, control of convulsions
was tenuous at best. Looking for an alternative, he drew upon his experience as an
epileptic specialist and his experiments with electroshock treatment to produce
repeatable and reliable epileptic fits in dogs to ascertain their effects.
The idea of applying ECT to humans came as a result of Cerletti’s
observation of pigs being anesthetized with electroshock before being butchered.
241
Convincing physicians Lucio Bini and L.B. Kalinowski to assist him, in 1937,
Cerletti worked to design and test a device that would deliver electroshock to
humans. The results were nothing short of astounding. The device proved reliable,
the administration controllable, and the outcome had unexpected beneficial results.
After treatment, ECT patients experienced retrograde amnesia, eliminating any
negative feelings associated with the procedure that had been experienced by
patients treated with Metrazol.
ECT was administered in a series of treatments over several weeks. The
patient was strapped to a gurney, gel and conductors applied to the temples, and a
bite guard placed in his or her mouth (this prevented the patient from biting his/her
tongue). The electricity was then sent to the brain in a predetermined strength and
length. This produced violent convulsions that many times resulted in broken bones
and vertebrae (later patients were sedated). Side effects included memory loss
(temporary to severe), headaches, nausea, confusion, and muscle ache or soreness.
While medical professionals were, and still are, unable to explain the exact
reason why this treatment works (it may be the result of neurotransmitters being
released in the brain as a result of the seizure); nevertheless, it proved to be the
“miracle” many doctors and patients were looking for, and it didn’t seem to damage
the brain.
To promote the use of ECT, in 1939, Kalinowski traveled the globe
eventually coming to the United States. Treating patients with severe depression,
who were resistant to other types of therapies, researchers found that depression
disappeared in 90 percent of the cases after three to four weeks. The results were so
profound, that in hospitals and asylums around the world ECT was heralded as the
panacea to depression;
242
but, its use soon became a “cure-all” for every type of
mental disorder, and indiscriminate use became widespread.
Sally J. Ling
94
In The Mad Among Us, Grob noted a study conducted by Horatio M.
Pollock in which the leading psychiatric statistician concluded: “The promiscuous
use of E.C.T. [sic] without other adequate psychiatric therapies has become a
medical scandal. Many institutions use it wholesale for all forms of mental illnesses
without any other therapyno proper nursing supervision, no occupational therapy,
no psychotherapy—simply a pure physiotherapeutic procedure.”
243
Over the years, ECT has been refined and remains the only somatic therapy
from the 1930s in widespread use today, as noted in this document on the Florida
Department of Children and Families website:
Electroconvulsive Therapy (ECT). ECT is a highly effective
medical treatment generally reserved for those with severe mental
illnesses who are unresponsive to or unable to tolerate medications or
other treatments. ECT may be used with severely depressed individuals
when other forms of therapy, such as psychotherapeutic medications or
psychotherapy, have not been effective, cannot be tolerated, or in life
threatening cases, when other treatments will not help the individual
quickly enough. ECT is most effective and most rapidly acting
treatment available for severe major depression. ECT also helps
individuals who suffer with most forms of mania, some forms of
schizophrenia, and a few other mental and neurological disorders. ECT
is also useful in treatment of these illnesses in older individuals for
whom certain medications may be unadvisable due to side effects.
Modern methods of administering ECT employ low “doses” of electric
stimulus to the brain along with general anesthesia and muscle relaxants
to minimize the risk and unpleasantness for the individual. Side effects
of this treatment may include mild confusion, memory loss, and other
cognitive problems which are common yet typically short-lived.
244
Lobotomies
Fever, insulin, Metrozol, and ECT therapies made a big a difference, but
without a doubt, psychosurgery (lobotomy) became the most striking innovative
therapy of the 1930s and became both a famous and infamous method of treatment
for tens of thousands of mental patients worldwide, including those at the Florida
State Hospital. The prevailing environment that allowed for the introduction of this
radical treatment included severe overcrowding at state institutions and the presence
Out of Mind, Out of Sight
95
of tens of thousands of chronic schizophrenic patients for whom shock therapies
were ineffective. This opened the door for psychosurgery to be introduced as a
promising addition to hospital-based therapies.
245
Sally J. Ling
96
Out of Mind, Out of Sight
97
Chapter Photo: Operating room. Photo courtesy of the Florida State Hospital.
Chapter VIII
Lobotomies: Cutting Edge Brain Surgery
The term lobotomy comes from two Greek words: lobos (lobe of the brain) and
tomos (to cut/slice). A neurological procedure, lobotomy, or leucotomy as it was
originally called, consisted of cutting the connections to and from the prefrontal
cortex located at the front part of the brain. Associated with memory, planning, and
decision-making, this portion of the brain is critically involved in behavior,
language, and reasoning.
Early Beginnings
Evidence of psychosurgery dates back to approximately 2,000 B.C., when
skulls found by archeologists showed evidence of precise holes that appeared to
have been intentionally bored. In a process called trepanation, some cultures bored
holes through the skull to allow evil spirits to escape. Although it is uncertain
Sally J. Ling
98
whether brain matter was extracted, the holes also might have been drilled to relieve
pressure in the skull.
246
Modern psychosurgery, known as leucotomy, had its roots in Switzerland in
1888, when Gottlief Burckhardt, psychiatrist and director of a mental asylum in
Switzerland, experimented on six mentally ill patients by removing pieces of their
cerebral cortex. Five of the six patients suffered from “primare Verrucktheit,” a
clinical category considered equivalent to schizophrenia.
247
Burckhardt claimed 50 percent success, with three patients showing partial
improvement. The procedure itself, though, coupled with inadequate patient follow-
up, brought harsh criticism from colleagues, and Burckhardt ended his research. He
summed up his pioneering philosophy in an 1891 paper: “Doctors are different by
nature. One kind adheres to the old principle: first, do no harm (primum non
nocere); the other one says: it is better to do something than do nothing (melius
anceps remedium quam nullum). I certainly belong to the second category.”
248
Two decades later, Estonian neurosurgeon Ludvig Puusepp operated on a
few patients; and, in 1935, Portuguese physician and neurologist Antonio Egas
Moniz performed a new surgery called prefrontal leucotomy. This involved drilling
holes in the skull and injecting alcohol to destroy the patient’s tissue in the frontal
lobes. Later, Moniz used an instrument called a “leucotome” that consisted of a
retractable wire loop that was inserted and then rotated to cut the brain tissue.
In his article “Controversial Psychosurgery Resulted in a Nobel Prize,”
Begnt Janssan noted that at the time no effective treatment existed for schizophrenia
and that leucotomy, at least, managed to make life more bearable. The treatment
became quite popular in many countries and Moniz received the Nobel Prize in
1949.
249
Drs. Walter Freeman and James Watts Perform First Lobotomy in U.S.
Intrigued by Moniz’s initial work, in 1936, American neurologist and
psychiatrist Walter Freeman hired neurosurgeon James W. Watts to perform the first
U.S. prefrontal leucotomy at George Washington University Hospital in
Washington, D.C. Alice Hammatt, who suffered with insomnia, anxiety,
depression,
250
and was facing institutionalization, became the doctors’ first patient.
Transcripts from “The Lobotomist,” the PBS special aired as part of the
American Experience, noted: “It was clear in those days when you were committed
Out of Mind, Out of Sight
99
Dr. Walter Freeman. Photo courtesy of National Library of Medicine.
to a mental hospital, this was not a voluntary affair, there was no way out. There
would be no treatment because there’s nothing seriously that anyone could do.
These were warehouses for people that society wanted to forget.”
251
Leucotomy, at
least, provided hope that the person could be discharged.
The procedure that Freeman and Watts used was through a burr hole in each
temple. Freeman would scrub up and position himself opposite Watts. Then guiding
Watt’s every move, Freeman would wave his hands this or that way to direct the
angle of insertion of the lobotomy instrument.
252
After the operation, Freeman
commented that Hammatt’s face reflected a placid expression, and by evening she
was quite alert, manifesting no anxiety or apprehension.
253
Sally J. Ling
100
Freeman and Watts operated on a dozen patients; and, while Freeman noted
altered behaviors, he also realized the patients suffered unsettling side effects, with
many experiencing reccurring symptoms requiring a second, and sometimes, a third
operation. Edward Shorter, a medical historian, stated in “The Lobotomist” that
Freemans definition of success was that the patients were no longer agitated. He
went on to explain: “That doesn’t mean that you’re cured, that means they could be
discharged from the asylum, but they were incapable of carrying on normal social
life. They were usually demobilized and lacking in energy. And they were that on a
permanent basis.”
254
Despite these dubious results, and upon occasion the patient’s death,
Freeman was not deterred.
Rosemary Kennedy: Freeman’s Most Infamous Case
Freeman and Watts received a call from elder statesman Joseph P. Kennedy
in 1941. The patriarch’s daughter, Rosemary, sister of John, Robert, and Ted
Kennedy, was described as “slow and shy-seeming from early childhood, possibly
dyslexic, and apparently retarded.”
255
Ronald Kessler, in his article “Rosemary Kennedy’s Inconvenient Illness,”
pointed out that Rosemary’s learning ability had always been slower than the other
Kennedy children, though as a teen she was quite capable of writing endearing
letters, dancing, and doing arithmetic. As she grew older, however, her temperament
“soured” and she often flew into uncontrolled and violent rages.
256
In a 2005 Washington Post article “Rosemary Kennedy, 86: President’s
Disabled Sister,” Martin Weil referred to an excerpt from a book by historian Doris
Kearns Goodwin in which it was stated that to Joseph P. Kennedy, Sr., a lobotomy
was an “obvious solution to the frustrations she [Rosemary] experienced in trying to
find a place for herself in a hard-driving [Kennedy] family.”
257
Dr. Brown, special assistant to President Kennedy and executive director of
the President's Panel on Mental Retardation, later learned from doctors retained by
the Kennedy family that Rosemary was not mentally challenged at all, but suffered
from depression. He concluded that the Kennedy family considered being mentally
challenged far more acceptable than being mentally ill.
258
Out of Mind, Out of Sight
101
Freeman and Watts performed their 66th lobotomy on Rosemary, then 23.
After mildly sedating her, Watts penetrated the brain through an incision in the
skull. Using an instrument resembling a butter knife, he cut the brain tissue by
moving the instrument up and down. During the operation Rosemary was asked to
perform cognitive exercisesto count backwards or sing a song.
Kessler interviewed Dr. Watts who explained that the doctors would
determine how far to cut based upon how Rosemary responded. When she started to
become incoherent, Freeman and Watts stopped.
259
The procedure left Rosemary
with the development of a two-year-old. She was unable to dress, wash, or clothe
herself and needed constant supervision.
Joe Kennedy sent Rosemary to St. Coletta's School in Wisconsin where she
received extensive custodial care. The family, who had represented themselves as
loving and caring, now ceased to acknowledge Rosemary’s existence. Letters,
written by Rose Kennedy did not refer to her, and Eunice later said she had no idea
where she was. The press didn’t learn the truth until John Kennedy was elected
president. Only then did Eunice feel comfortable talking about Rosemary in public.
On the premise that Rosemary was mentally challenged, Eunice Kennedy Shriver
founded Special Olympics International, Inc. in 1968.
260
Rosemary remained permanently incapacitated until her death at Fort
Atkinson Memorial Hospital in Wisconsin on January 7, 2005.
Lobotomies in the Sunshine State
In the southernmost state of Florida, another physician, Dr. James G.
Lyerly, Sr. became intrigued by Monitz’s work. Lyerly graduated in 1920 from
Medical College of Virginia, and after interning at Memorial Hospital, served
several years under Dr. C.C. Coleman, Professor of Neurosurgery. Moving
permanently to Jacksonville, Florida, in 1934, with his wife Emily and three
children, he set up a solo practice. At the time, he was the only neurosurgeon in
Florida, with others located in the southern cities of Richmond, Atlanta, New
Orleans, Memphis, and Louisville.
261
Developing a relationship with Dr. Ralph Greene, Sr., a Jacksonville
neurologist who had served several years as superintendent of the Florida State
Hospital, Dr. Lyerly, Sr. became informed about the hospital and its need for a
neurosurgeon. Dr. Edward Sullivan, one of Dr. Lyerly, Sr.’s associates who later
Sally J. Ling
102
Dr. James Lyerly, Sr., a neurosurgeon
from Jacksonville, Florida, performed
lobotomies at the Florida State Hospital.
Photo courtesy of the American
Association of Neurological Surgeons’
Cyber Museum of Neurosurgery
assisted him with lobotomies at the hospital,
recalled that in Dr. Lyerly, Sr.’s earlier
association with the hospital, he would visit
once a month: They would give him a list of
patients to evaluate and offer an opinion, and
occasionally he would schedule an operation
for subdural hematoma or a benign brain
tumor.
262
Dr. Lyerly, Sr.’s work with the
mental patients eventually piqued his interest
in the emerging psychosurgery known as
lobotomy. Following Monitz’s lead, he
devised his own procedure, which later
became accepted worldwide. This procedure
was an open operation done over the frontal
lobes through two trephine openings,
allowing visualization of the cut fibers and
bleeding control if necessary.
263
Proper patient selection was highly
important to Dr. Lyerly, Sr. as he firmly
believed that not all mental diseases would benefit by this operation;
264
therefore, he
performed lobotomies only on cases of severe involutional melancholia and agitated
depression.
265
The type of lobotomy to be performed was determined by the severity of the
mental disorder. Unilateral prefrontal lobotomy (on one lobe) was preferred in
milder forms of mental disorders or on young patients when the least change of
personality was desired. Bilateral prefrontal lobotomy (both lobes) was performed
when ECT failed or another procedure was indicated. It was also used for the relief
of drug addiction, intractable pain, and on patients with nervous and mental
symptoms.
266
Initial patients at the Florida State Hospital on whom Dr. Lyerly, Sr.,
performed lobotomies from October 1937 to March 1938, included four males and
three females, ages 47 to 66. Each suffered from involutional melancholia, a mental
illness characterized by severe depression, feelings of wanting to die and/or
attempted suicide that lasted four months to two years.
267
In his article “Transsection
Out of Mind, Out of Sight
103
of the Deep Association Fibers of Prefrontal Lobes in Certain Mental Disorders”
published in The Southern Surgeon, Dr. Lyerly, Sr. described how he determined
which patients would benefit from the operation:
In every case the patient was examined by a psychiatrist before the
operation. If these patients are not benefited over a reasonable
period of time under the medical and psychiatric treatment, rather
than let them stay in some hospital indefinitely while mental
deterioration sets in, it may be better to give them the benefit of the
operative procedure outlined, when a remission is secured in a few
weeks time. The time saved in restoring the patient to society, the
lessening of the financial burden, the relief from mental suffering,
and the lives saved from suicide and inanition are important factors
in favor of the operation.
268
To perform the operation, Dr. Lyerly, Sr. removed two small buttons of
bone on either side of the forehead at the hairline, opened the dura, and made an
incision in the cortex. A lighted brain speculum was inserted and the associated
fibers cut diagonally. The dura was then closed and the buttons of bone replaced in
the wounds.
269
Lylerly’s Lobotomy Patients
Dr. Lyerly, Sr. noted that many of the patients he treated at the hospital had
been in restraint for 10 to 15 years. After the lobotomies, some showed remarkable
improvement. Most were able to function without the use of restraints, and some
were eventually discharged and became employed.
One of Dr. Lyerly, Sr.’s patients, a 12-year-old feeble-minded child
described as psychotic, remained constantly agitated, restless, noisy, and was a
disturbance to the other children in the institution. After a lobotomy, Dr. Lyerly, Sr.
noted that although the young girl remained institutionalized, it was much easier to
take care of her.
270
Another patient, identified only by the initials J.H.M., was a white druggist,
aged 47, who was married with two children. A physical examination showed he
was in good health, and there was no family history of mental illness prior to his
admission to the hospital on May 29, 1937. According to records, his symptoms
started three months prior with worry and depression that gradually became worse.
Sally J. Ling
104
He frequently cried, his memory became impaired, he felt as if he had wronged
people, and everybody was against him. In addition, he felt as though an unknown
power was driving him down. He had attempted suicide on two occasions.
271
During his stay in the hospital J.H.M.’s symptoms did not improve.
272
Diagnosed with involutional melancholia, on November 29, 1937, Dr. Lyerly, Sr.
gave J.H.M. a lobotomy.
On the first postoperative day the patient said he felt better and was
smiling. His outlook was brighter; he did not worry. He said he
wanted to go home and help his family. On the fifth day he was a
bit confused and complained of a little headache. Sutures were
removed on the sixth day and the wound was healed. On the next
day he smiled and asked questions readily. He was slightly worried
about his wife and children. He was not depressed. He was brighter
and more alert. He said he wanted to go to work. He was furloughed
from the hospital to his home on the fortieth postoperative day, Jan.
8, 1938. At that time, the patient was alert, and the future looked
bright and excellent.
273
After discharge, Dr. Lyerly, Sr. received several letters from the patient’s
wife expressing thankfulness that her husband had been restored to his home and
family and that his attitude and personality were better than she had ever known
them to be.
274
One of the doctor’s more notable cases involved a patient nicknamed “the
old metal eater.Constantly eating odd objectsnails, spoons, and other metals that
he could swallow, in addition to twigs, wood, paper, and any other foreign material
he could get his hands on—he’d undergone numerous abdominal operations to
remove the foreign objects and intestinal obstructions. Unable to quit this obsession,
he was finally given a lobotomy. Following the operation, he improved
significantly, and his tendency to swallow foreign material abated.
275
Results of the elder Lyerly’s first seven operations indicated that five of the
patients became “well, and two “greatly improved.” Four of the patients were
discharged from the hospital within 10 weeks of their operation; and, at the time of
the report, several were still recovering.
With the growth of Dr. Lyerly, Sr.’s Jacksonville practice, in 1947, he
established a board-approved one-year neurosurgical residency program at St.
Vincent’s Hospital.
276
Dr. Edward “Sully” Sullivan, a graduate of Georgetown
Out of Mind, Out of Sight
105
The Lyerly Group: Drs. Edward Sullivan, Tom Boulter, Howard Chandler, James Lyerly, Sr.,
James Lyerly Jr., Gaston Acosta-Rua. (mid 1970s) Photo courtesy of Dr. James Lyerly, Jr.
University School of Medicine who studied under Dr. Walter Freeman while a
medical student assigned to the neurosurgery department at Gallinger (Public)
Hospital in Washington, trained as a resident in this program from 1948-1950.
In 1954, he became an associate of the Lyerly practice and in 1956, became
partners with Dr. James G. Lyerly, Sr. and his son, Dr. James G. Lyerly, Jr., when
the three formed the Lyerly Group (now known as Lyerly Nuerosurgery). Later,
Sullivan served 20 years as Chief of Neurosurgery at St. Lukes Hospital in
Jacksonville, Florida.
277
Sullivan assisted Dr. Lyerly, Sr. with lobotomies at the
Florida State Hospital for five years. Describing their routine, he said they got up at
4:00 a.m. and drove to Chattahoochee once a month where they operated about 9:00
a.m. Sullivan said the two performed one or two lobotomies a day and that he
participated in about 100 at the Florida State Hospital, with many having “fantastic
results.”
278
One of the private patients on whom Sullivan performed lobotomies was a
nurse who had tried to commit suicide several times. On the first occasion she tried
to asphyxiate herself by turning on the gas in her oven.
Sally J. Ling
106
Alerted by the smell, a neighbor rescued her. On her last attempt, she shot
herself on the right side of the temple with a .45 automatic. As the gun contained old
ammunition, the bullet didn’t penetrate very deeply into the right temporal lobe.
Sullivan stopped the bleeding; yet, knowing she had tried several times to commit
suicide, he performed a unilateral lobotomy. After that, she never tried to commit
suicide again,” stated Sullivan.
279
While Dr. Lyerly, Sr. performed open lobotomies and hosted physicians
from the Mayo Clinic who came down to observe his method,
280
Walter Freeman
was in the throes of developing a new techniqueone that was both revolutionary
and revolting.
Freeman Introduces “Ice Pick” Lobotomy
Freeman’s initial technique involved drilling into the skull, a procedure that
required an operating room and trained neurosurgeons. These accommodations,
however, were not available in many mental institutions. To make matters worse,
during and at the end of World War II, thousands of traumatized service men
returned home to state institutions that were horribly overcrowded. In fact, in 1943,
state mental institutions admitted 100,000 new patients with only 67,000 discharges.
Three years later, admissions rose to 271,000; and, just a year earlier, mentally ill
patients occupied approximately one-half of public hospital beds.
281
This situation
prompted Freeman to consider a more simplified technique. By training psychiatrists
to carry out the procedure in state hospitals that had limited financial resources and
no operating rooms, surgeons, or anesthesia, he hoped to help the 600,000 patients
now occupying those facilities.
Freeman first used his new technique in 1946 on Ellen Ionoesco, a 29-year-
old housewife and mother considered so depressed she stayed in bed for days on
end.
282
Freeman rendered her unconscious through the use of electric shock, and
then peeled back her eyelid. Using a common ice pick, and keeping it in the same
plain as the nose, he pushed the instrument into the orbital cavity (just above the
eye) until it hit thin bone. With the tap of a hammer, he punctured the skull and
inserted the instrument until the prefrontal area was located. Freeman then moved
the ice pick “back and forth like a windshield wiper.
283
Out of Mind, Out of Sight
107
Dr. Walter Freeman gives a lecture on transorbital lobotomy to staff at Western State Hospital in
Tacoma, Washington. Freeman gave up a portion of his vacation, which he was spending in the
Pacific Northwest, to introduce the procedure, as well as supervise the selection and operation of
the initial thirteen cases. Photo courtesy of Western State Hospital.
Harry Merliss, M.D., Freeman’s former student who was present to study
the technique, said he had a hard time being part of the innovative treatment: “When
I walked in that room the first time, and to see this thing, I really wanted to run. I did
not want to be there. To see somebody nailing, what I call a nail, through
somebody’s skull. I just could not see at eighteen years old how that made any
sense.”
284
Merliss wasn’t the only one to balk at the new procedure. When Watts saw
this technique performed for the first time, he threatened to break off his partnership
with Freeman if he continued to perform lobotomies himself and treat them as
office procedures done without surgical gloves or sterile draping.From then on,
Freeman performed this procedure alone and outside the office.
285
By lining up hospitals that wanted to learn the technique, Freeman traveled
the country in his own personal van that he called his “lobotomobile.” If hospitals
weren’t available he’d perform the operation in a hotel room, often lobotomizing
Sally J. Ling
108
Dr. Freeman gives twelve-year-old Howard Dully an ice pick lobotomy. Photo courtesy of
Howard Dully and the Special Collections Research Center, Gelman Library, George
Washington University.
children as young as 12 for delinquent behavior, and housewives who had lost their
zeal for domestic work.
286
Lobotomy Boom and Bust
In his article “Frontal Leukotomy and Related Psychosurgical Procedures in
the Era Before Antipsychotics,” Dr. Victor W. Swayze, II described the factors that
contributed to the escalating use of psychosurgery: “First, there were no alternative
therapies available for chronically institutionalized patients who had already
received somatic treatments and had only a temporary response or none. In a time
when little could be done . . . it was remarkable that dramatic changes in symptoms
were frequently observed within a relatively short time after an operation.”
287
During the 1940s and 1950s, dozens of doctors around the world performed
tens of thousands of lobotomies using a variety of techniques.
288
Freeman himself
recorded 3,439 lobotomies in 55 hospitals in 23 states,
289
most with his new
assembly line technique designed to reduce time and the necessity for an operating
room and surgeon. In February 1967, Freeman’s lobotomy career came to an abrupt
end when Helen Mortenson died of a brain hemorrhage. He lost his hospital
privileges and shortly thereafter retired.
290
Out of Mind, Out of Sight
109
Later, at the age of 72, Freeman traveled the country trying to locate his
former patients. By speaking to them, he was hoping to prove to the world that
lobotomies hadn’t been the great medical disaster people thought they were.
291
He
died of cancer on May 31, 1972.
End Results in Florida
From 1937 to 1951, Dr. Lyerly, Sr. performed 182 lobotomies, many at the
Florida State Hospital. Of the reported cases, 72 involved relief from involutional
melancholia, 25-manic depression psychosis, 35-schizophrenia, 30-psychoneurosis,
17-intractable pain, two-Parkinson’s Disease, and one was psychopathic feeble
minded ness. Of these, 90 of the patients were discharged (went home and became
employed), 44 showed moderate improvement (home but not yet employed, though
capable of doing so), 42 showed slight improvement (still in the hospital), and six
were considered failures (showing no improvement).
292
During 1950, three deaths were documented; however, autopsies indicated
these occurred from other complicating illnesses and not as a result of the
lobotomies.
293
According to Sullivan, Dr. Lyerly, Sr. never used Freeman’s “ice
pick” technique privately, and no records indicate this procedure was ever
performed on patients at the Florida State Hospital.
Writings from Dr. Lylerly, Sr. coupled with personal interviews from Dr.
Lylerly, Jr. and Dr. Edward Sullivan, note that lobotomies were a significant part of
patient treatment at the Florida State Hospital from the 1930s through the 1950s.
Curiously, however, hospital biennial reports do not include any information
regarding them and only mention Dr. Lylerly, Sr. in cursory fashion when noting
that neurosurgeries were performed at the hospital.
294
Lobotomies continued in great numbers until 1955, when Thorazine was
approved for use in the United States. Called a “chemical lobotomy,” the drug was
prescribed for patients suffering from schizophrenia and severe depression and
resulted in improved mood, making it easier for them to function in everyday life.
Once Thorazine was introduced, the need for lobotomies dropped significantly.
After Dr. Lyerly, Sr. no longer performed lobotomies at the Florida State Hospital or
in his private practice, Dr. Lyerly, Jr., stated, “My father never spoke of them
again.
295
Sally J. Ling
110
While Thorazine ushered in decades of development, testing, and the use of
other antipsychotic drugs, a number of lobotomies are still performed today.
Out of Mind, Out of Sight
111
Photo: New fire station. Photo courtesy of the Florida State Hospital, Florida State News Bureau,
Tallahassee.
Chapter IX
Hope and Challenges
Innovative treatments of the 1930s continued into the next decade bringing hope for
increased patient discharges to institutional mental health care workers; but, day-to-
day reality was quite sobering. The Florida State Hospital experienced its largest
patient population to date and moved into the middle of the decade remarkably
understaffed due to the involvement of our nation’s men in a history-altering
eventWorld War II. This event, though, would produce some unexpected positive
results in the field of mental health care.
World War II Introduces New Challenges and Treatment Philosophy
The war created a swell in patient population from discharged soldiers that
added to the already overcrowded situation in the hospital, and it created a
secondary challenge to the administrationloss of medical staff to the war effort.
296
Sally J. Ling
112
Even the dental department felt the pinch when seven of 12 persons on staff entered
the armed services leaving the department with the most changes in personnel in the
department’s history. With openings difficult to fill, the department operated with
personnel comparable to that of 15 years prior and a patient load of almost double
that period. As a result, there was an increase in the number of emergency
operations and a reduction in the number of restorative operations.
297
The war did prove, though, to have positive effects as well. This came in the
form of a shift in philosophy of treatment. According to Grob:
During that conflict, military psychiatrists found that
neuropsychiatric disorders were far more pervasive and serious than
had been previously recognized, that environmental stress
associated with combat contributed to mental maladjustment, and
that early and purposeful treatment in noninstitutional settings
produced favorable outcomes. . . A logical conclusion followed:
treatment in civilian life, as in the military, had to be provided in a
family and community setting rather than in a remote, isolated, and
impersonal institution. . .
298
This change in thinking, plus the discharge of many military psychiatrists
into the medical community at the conclusion of the war in 1945, helped launch a
philosophical change in the way the mentally ill were treated. Contributing to that
change were several writers.
Writers Support Changes
In 1944, liberal journalist Albert Deutsch began investigating psychiatric
facilities. Over the next two years, he wrote several dozen articles exposing the
deficiencies and harsh realities of patient care in the nation’s mental hospitals. These
insufficiencies were echoed in state hospitals around the country as overcrowding
and understaffing took its toll on patients, such as those depicted by Deutsch in a
Detroit hospital:
Above the occasional shriek, the hysterical crying and senseless
laughter, the moaning and the muttered soliloquieswas the
oppressive crowding of the nervously sleeping inmates of the
depressing, dirty, dim-lit wards.
Out of Mind, Out of Sight
113
Cots and beds were strewn all over the place to accommodate the
289 mental patients packed into wards intended for 126. Cots lined
the corridors, with restless patients often strapped into them. (It
appeared that about one-third of all patients in the psycho wards
were under mechanical restraint that nighttied down to their beds
by leather thongs, muffs or handcuffs linked to chairs.) . . .
I had noticed, during the day, an unusually large number of women
patients in bed. An attendant, when I asked about this, replied that
there wasn’t enough clothing to go around . . . and it was necessary
to keep many in a bed to preserve some semblance of decency.
299
It was Mary Jane Ward’s 1946 autobiographical novel The Snake Pit,
condensed in Reader’s Digest and later made into a motion picture in 1948, that
generated the most eye-opening portrait of mental hospitals, softened only by the
potential found in psychoanalytic psychiatry.
In the movie, the heroine, who was committed to a hospital because of a
mental breakdown, was treated by a caring psychiatrist who employed
psychotherapy to help her gain valuable personal insight.
300
This portrayal of the
effective use of psychotherapy helped to promote its use as treatment.
With support for change converging from a number of sources, the country
underwent a major overhaul in its philosophical approach to mental health care.
Among those changes was the passing of the National Mental Health Act in 1946.
Theresa Walls in her article “The National Mental Health Act of 1946 and the
Establishment of NIMH: Ongoing Challenges,” noted that: President Truman
signed this bill into law in the immediate post war period which heralded a dramatic
shift in the care of the mentally ill. This shift, primarily engineered through
education and research, would ultimately solidify the move from institutionally
based care (the asylum model) to community based care.”
301
The Act also provided for the creation of the National Mental Health
Advisory Council and the establishment of the National Institute of Mental Health
(NIMH) in 1949. NIMH’s stated mission was “to transform the understanding and
treatment of mental illnesses through basic and clinical research, paving the way for
prevention, recovery, and cure.” This mission was carried out in its headquarters in
Bethesda, Maryland, and multiple research offices across the country.
302
Sally J. Ling
114
Main Receiving Hospital. Photo courtesy of the Florida State Hospital.
Hospital Becomes a Small City
By the end of 1940, the Chattahoochee facility grew to become a sprawling
10,278-acre self-sufficient complex the size of a small municipality. Buildings
numbered 280 with a staggering 4,515 patients and 888 employees, 216 of which
worked the farm and were prisoners from the Florida State Prison at Raiford in
central Florida.
303
Covering 2,691 acres, the farm produced 2,147,969 pounds of
fresh vegetables a year along with thousands of pounds of Irish and sweet potatoes,
pecans, corn, pears, watermelons, and cantaloupes.
304
Dairy and poultry farms
provided meat, milk, butter, and cream.
Maintained by its own power, sanitation, and refrigeration plants, the
hospital complex also contained its own communications department, including
telephone, telegraph, and radio. The Mattress Factory, housed in the old arsenal
magazine, used surplus cotton and ticking to produce 1,801 cotton mattresses and
1,776 pillows. Adding to the compound’s self-sufficiency were support facilities
including a canning plant, carpenter shop, saw mill, foundry, garage, and broom and
mop factory.
305
Out of Mind, Out of Sight
115
Occupational therapy was conducted in the art room of the white female
department and incorporated creative and useful activities including basketry,
weaving, painting, wood-carving, rug hooking, knitting, crocheting, and embroidery.
These crafts, sold at a price high enough to pay for the materials, proved to be
particularly beneficial for some types of mental disorders.
306
Along with the School of Nursing, two new schools were addedMedical
Technology and Attendant’s Training. These schools graduated 22 nurses along with
77 aids and orderlies.
307
In the latter part of the decade, men were admitted to the
nursing school for the first time.
308
The Dental Department made great strides during this decade as well,
offering free dental service for employees with a nominal charge for materials. It
was described as the most modern and completely equipped [dental] clinic of its
sort in any state maintained mental institution in the United States.” Ample
reception space for white patients and employees, separate reception-room,
operating-room and sterilizing facilities for the black patients and employees, were
its most outstanding assets.
309
On the clinical side, for the first time medical staff made progress notes on
the patients following admissionweekly for four weeks, monthly for five months,
and every six months thereafter.
310
While this greatly improved the ability to follow
a patient’s progress, in another arena physicians were functioning under a severe
handicap when overcrowding at the facility produced long delays in patient’s
admittance and led to unwillingness on the part of the patients to give accurate and
complete information concerning their mental illness.
311
To help alleviate the severe overcrowding and free up beds, patients were
furloughed to their families if the physician thought the patient had recovered
sufficiently. The furlough was for one year, at the end of which the patient would be
discharged by virtue of having been absent one year on furlough. If necessary,
however, the patient could return to the institution at any time during the year.
312
Using this method, thousands of patients were furloughed over the decade.
Unfortunately, as many as one-third of the patients, unable to “make it” on the
outside, were eventually returned to the institution.
Furloughs weren’t the only way patients separated themselves from the
hospital. Reports during this time indicate that hundreds of patients escaped,
including three who eloped with their husbands. As many as 78 percent of the
escapees were found and returned.
313
Sally J. Ling
116
Above: Woodworking shop. Below: Upholstery shop. Photo courtesy of the Florida State
Hospital.
Out of Mind, Out of Sight
117
Sam Cunningham, the hospital’s clinical psychologist for 38 years, recalled
the “unwritten” procedures that followed elopements during his tenure (1950-1988):
“It depended upon who broke out. If the patient had been there a while with good
contact with reality but no one to sign him out, they would go look for him but
wouldn’t call out the National Guard; however, if others eloped, they would go
through considerable efforts to find them. One time they went looking for nine and
found fourteen.”
314
As the hospital serviced not only the needs of the mental patients but staff
and their families as well, it was not unusual for the babies of staff and their families
to be delivered by hospital doctors.
315
Most newborns were sent home; however,
incidents included the death of several infants, a patient that escaped with her
newborn son, and other patients who gave birth.
Records do not indicate whether births by patients were due to the woman
becoming pregnant before or after admittance. In all the records reviewed, there was
no indication that sexual abuse by staff caused any patient pregnancies; however,
several biennial reports noted that some babies were adopted out when the hospital
was unable to locate relatives of the patient, or the relatives were unable or
unwilling to take the child.
316
Nine-Hole Golf Course Results in Joy and Controversy
In the 1940s, Dr. J.H. Therrell, hospital superintendent, headed an
association composed of doctors, hospital staff, and local townsfolk wanting to build
a golf course on hospital grounds. With minimal dues and fees to fund the
construction and operation of the course, it started with just a few holes; but, over
the years, other holes were added until the course expanded to nine holes. The
course was named Thronateeska, meaning “giving forth,” the name the Creek
Indians gave the Flint River (the Chattahoochee and Flint Rivers unite to form the
Apalachicola River at the Georgia/Florida State line).
According to Norman “Champ” Jones, the hospital’s utilities and
maintenance supervisor from 1973-1993, Jules “Jimmy” Terrell, a horticulturalist
and hospital grounds manager, knew folks in the golf course business in Marianna,
Florida, and visited several courses to collect sprigs of grass. The association then
built dirt mound greens, planted the sprigs, and assumed responsibility for weeding
and other maintenance as required.
317
Sally J. Ling
118
Hospital staff and local townspeople played the course and became most
fond of it. In fact, it was so popular that it underwent a redesign in the 1960s. The
facility fell into jeopardy in the 1970s when Health and Rehabilitative Services
officials started looking for a location to build a new forensic unit to house mentally
ill criminals. The preferred site was right in the middle of the existing golf course.
318
Upon learning that the forensic unit would replace their beloved golf course,
Chattahoochee citizens engaged in a spirited defense. A deal brokered by Senator
Pat Thomas and Representative James Harold Thompson ultimately allowed the
forensic hospital to be built with the caveat that another golf course would be funded
in the future. Several years passed, however, with no movement toward that end.
Then, during the 1983-1984 legislative session, $200,000 was appropriated. The
new Seminole Valley Golf Club, complete with driving range and restaurant, opened
in 1986.
Carved out of undulating woodland terrain in the northernmost section of
hospital grounds, the well-manicured course was extremely popular with locals,
state officials, and anyone else fortunate to know about this well-kept secret.
Concealed near the forensic unit, no signs directed golfers to the clubhouse and only
those who knew of its existence were able to find it. Even so, periodic tournaments
helped raise money for the hospital’s patients, local schools, and civic clubs.
319
Jim Baraneau, who worked at the hospital since 1986, retired in 2010, and
was intimately involved in the restoration of the old powder magazine, said that true
golfers loved the course because it was a shot maker’s course: “On the par five you
used a three iron off the tee. The number one tee was in Florida and, if you hit a
decent drive, your ball would land in Georgia. You played in Georgia until your
approach shot to the number nine green.”
320
All went well until 1993 when Jenni Bergal, a Sun Sentinel newspaper
reporter from South Florida, questioned why the Florida Department of Health and
Rehabilitative Services was running a golf course. In her article “Golf Might Be
Good for One’s Mental Health, but HRS Goes Too Far,” Bergal stated: When you
play there, you make out your check to HRS. The staffers work for HRS. Even the
scorecard bears the HRS logo. How could this be? Why are social service
employees running a golf course on the grounds of a 1,002-bed mental hospital?”
321
Amid a growing scandal that took $49,000 a year out of the HRS mental
health budget to pay salaries and benefits for employees who worked at the course
and resulted in an over $7,000 annual deficit,
322
HRS leased the golf course to a man
Out of Mind, Out of Sight
119
from Albany who ran the facility until 1994. After a flood ruined the golf course and
the man lost his home in the same disaster, the lease was turned over to a second
individual who proved unsuccessful. It was subsequently leased to a third group
from Dothan, Alabama. Unfortunately their director, who was also the most
experienced in the golf business, suffered a debilitating stroke before the course
became operational. Unsuccessful in its attempts to attract others interested in
managing the course, the hospital returned the property to the Department of
Corrections.
323
Today, if you consult Google Earth, you can clearly see the nine abandoned
holes of what once was the Seminole Valley Golf Course described by Bergal as “a
gorgeous place, with hilly woodlands and stone bridges that cross over clear
streams.”
324
New State Hospital Opens
In 1947, 759 patients from the Florida State Hospital at Chattahoochee were
transferred to the remotely located 2,173-acre Florida State Hospital No. 2 in
Arcadia,
325
a small town in southwest Florida. Named the G. Pierce Wood State
Hospital after a north Florida legislator who lived in Arcadia, the facility was
intended to relieve overcrowding at Chattahoochee, service long-term patients, and
those patients coming from the southernmost part of the state.
Hospital facilities were built on two abandoned military airfields
Carlstrom Field and Dorr Field. The fields were located seven miles apart and were
used by the Army to train pilots during World War I. Decommissioned at the end of
that war, the fields were abandoned and many of the buildings sold or demolished.
With the advent of World War II, the fields were chosen as the site for a
contract pilot training school run by the Embry Riddle Academy, a civilian
contractor. New facilities were built, and both fields opened in 1942. Mark Ball, a
flight instructor at Carlstrom Field from October 1942 to October 1943, noted that
Carlstrom Field trained British pilots while Dorr Field trained American pilots.
326
Over 8,000 cadets trained at Carlstrom Field, and over 700 trained at Dorr.
327
At the
end of World War II, both Carlstrom and Dorr Fields were sold to the State of
Florida for a total of one dollar and their facilities converted into the G. Pierce
Wood State Hospital.
Sally J. Ling
120
Top view: Dr. J.H. Therrell, director of Florida State Hospital at Chattahoochee and Terry Lee,
coordinator of State institutions inspecting wards newly opened at the G. Pierce Woods Hospital
in Arcadia, Florida. Photo courtesy of the Florida State Archives.
The facility was divided into two sections, each with its own hospital, and
staffed by two doctors, including the Clinical director and two graduate nurses. The
men’s division at Carlstrom Field received 317 white male patients; Dorr Field
received 442 white female patients.
328
Among the first female patients to arrive from
Chattahoochee was Theresa Castiglioni.
Out of Mind, Out of Sight
121
Case History
Theresa Castiglioni (Admitted April 1932, Discharged 1974)
Born in 1901, in Canada of Czechoslovakian parents, at age 17, Theresa met
and became pregnant by Spartaco Castiglioni, a blue-collar worker of Italian descent
who was ten years her senior. Married to Spartaco, Theresa gave birth at age
eighteen to their first child, Ernest D. “Didier. In 1920, the family emigrated to the
U.S. and took up residency in Orlando, Florida. During the next eight years, Teresa
gave birth to five more children.
329
After the South Florida hurricane of 1928, the
family moved to West Palm Beach because Spartaco heard there was plenty of work
reconstructing homes.
On April 4, 1930, Gloria, the couple’s second youngest daughter who was
three and a half, was pronounced dead at the Good Samaritan Hospital in West Palm
Beach. The death certificate stated: “Burned 1st & 2nd degree 3/5 of body by fire.
Clothing caught fire by child playing with matches.”
330
According to Gloria’s sister Isabel, their father Spartaco was a heavy
smoker who used pack matches to light his cigarettes. One day while cleaning, the
matches were swept out into the yard where Gloria found them. Wanting to cook
some cherries, the young girl lit a match that subsequently caught her clothes on
fire. While she survived a few days in the hospital, she eventually succumbed, due
to complications from the burns.
Theresa was so traumatized by the event that she cried all the time and
reverted back to speaking French (she was French Canadian), a language the
children could not understand. She also vehemently blamed her husband for having
the matches around in the first place.
In 1931, Spartaco had Teresa placed in a local hospital for treatment. Later,
on April 21, 1932, by order of Judge Cook, she was transferred from West Palm
Beach to the Florida State Hospital.
331
Her diagnosis was listed as “chronically
insane.”
332
Dr. Larry Annis, who at the time of his interview was Chief Psychologist at
the Florida State Hospital, stated that the term chronically insane was not a
clinical term, because diagnostic criteria weren’t firmly established in the 1930s and
1940s. He explained that basic insanity is not being able to tell the difference
Sally J. Ling
122
between right and wrong and not being able to conform to the accepted mores
because interpretation of what is normal is off.
333
According to Isabel, her father tried to visit Theresa but she flew into a rage.
She didn’t want to come back to him, and she blamed him for Gloria’s death.
334
Spartaco never visited Theresa again, nor did he speak of her, assist in her
rehabilitation, or try to get her released. In essence, her existence vanished from
family conversation. In 1935, Marjorie Barber, a family friend, moved into the
Castiglioni home to assist Spartaco in the care of the children. She subsequently
became his common law wife and assumed his last name.
After spending fifteen years at the Florida State Hospital at Chattahoochee,
in 1947 Theresa was “furloughed” (moved) to a the facility at the G. Pierce Wood
State Hospital in Arcadia, Florida.
335
She stayed in the facility until 1974 when the
deinstitutionalization process swept the state. After 42 years in the Florida State
Hospital system, she entered a nursing home in West Palm Beach and later Lake
Worth. Her granddaughter Viki White stated: “Her neglect and being there [at the
hospital] so long had made it improbable that she could be released on her own.”
336
Delores and Isabel continued to visit their mother until her death in 1989.
337
Arcadia’s Last Years
By the end of 1954, the Arcadia facility had 1,228 patients and, like
Chattahoochee, the facility was self-contained with water, ice, and sewage treatment
plants, and a fire department. It also had recreational and occupational therapy
departments, beauty parlor, barbershop, and sewing rooms.
338
Recreational activities took place in a large hanger formerly used by the
Aviation Corps and, along with board games, included volleyball and shuffleboard.
Softball was played three times a week, and weekly dances were held with patients
at both Carlstrom and Dorr Hospitals.
The facility operated until 2002, when the decision to close G. Pierce Wood
followed a series of incidents that ended in death and injury to several patients.
339
Cited in a Civil Rights of Institutionalized Persons Act (CRIPA) proposed
investigation dated March 23, 1995, the incidents included suicide by hanging, an
unobserved patient who cut off both hands, and three patients that died in a single
week.
340
Out of Mind, Out of Sight
123
While a federal judge ruled the hospital “adequate,” state officials decided
that closing the facility would save money and that community treatment programs
and patients living in supervised apartments would result in better care.
341
James K.
Green, a West Palm Beach lawyer who waged a 17-year legal battle to improve care
at the hospital noted: “This hospital, and a lot of other state hospitals like it, is a
dinosaur. The fact of the matter is, people get better, quicker, and cheaper care when
they’re closer to their home communities and families.”
342
Community-Based Treatment Advocated
During the 1940s, hope laid the foundation for the next decade. Advances
made in psychiatry during the war helped augment the theory that community-based
treatment would be preferred over mental hospitals, and the infusion into psychiatry
of young military physicians that were trained in psychodynamic concepts helped
strengthen that theory. This, along with the formation of the National Institute for
Mental Health, laid the foundation for change. It was a start, but it would take years
before these organizations established tangible improvement in care for the mentally
ill.
While the next decade saw the discovery of a new psychotropic drug that
dramatically impacted patient treatment, commitment procedures were still quite
primitive; but, that was about to change. The commitment of Kenneth Donaldson to
the Florida State Hospital in the mid-1950s set wheels in motion that would
eventually alter patient rights and admission procedures on a national levelchange
that was long overdue.
Sally J. Ling
124
Out of Mind, Out of Sight
125
Photo: Hospital kitchen. Photo courtesy of the Florida State Hospital.
Chapter X
Procedural Status Quo,
Medical Discoveries
and the Wind of Change
By 1952, Chattahoochee had 6,223 patients with the average cost to maintain each
running $2.02 per day.
343
The annual budget allocated salaries for 20 physicians, but
only 12 were on staff to treat thousands of patients as well as hospital employees
and their families. Reasons for the lack of an adequate number of physicians were
many. First and foremost, only a small percentage of physicians were actually
interested in psychiatry, and this decreased substantially when institutional work
was thrown into the mix. Second, even though salaries were combined with certain
perks, they fell far below that which would attract the average physician unless he
happened to have another source of income. Finally, the isolated location of
Chattahoochee proved unattractive to men with families.
344
Exacerbating the overcrowding of the hospital was the passing of House Bill
No. 926 on May 26, 1951. Known as the Child Molester Act, the bill was to
Sally J. Ling
126
“provide for the sentencing, commitment, treatment, parole, release and discharge of
persons convicted of certain sex offenses against persons under the age of 12
years.”
345
Under the provisions of the act, an offense included the following: rape,
attempted rape, sodomy, attempted sodomy, crimes against nature, attempted crimes
against nature, lewd and lascivious behavior, assault (when a sexual act was
completed or attempted) and assault and battery (when a sexual act was completed
or attempted).
346
Before sentence could be pronounced, however, the trial judge required an
examination and written report. The examination was to be conducted by two court-
appointed and licensed physiatrists with five or more years of practice in the
diagnosis and treatment of mental disorders. Written psych reports were to include
the following: social history, criminal record, circumstances of the offense, physical
and mental examination, and all the facts and findings necessary to assist the judge
in passing the sentence, including the likelihood of repetition of the offense.
Once sentencing was pronounced, it was the responsibility of the
Superintendent of State Hospitals and the Board of Commissioners of State
Institutions to assign psychiatrists, clinical psychologists, and psychiatric social
workers to diagnose and prescribe treatment that would either cure or rehabilitate
those committed under this act.
347
When the law took effect, the courts began sending persons convicted of
child molestation to Chattahoochee when prior to that they were sent to the State
Prison at Raiford.
348
While the transfer of these patients dramatically increased the
patient load of the physicians, it also came with an opportunity when Princeton
University Department of Psychology asked the hospital to participate in
standardizing the Tomkins-Horn Picture Arrangement Test.
349
The test, consisting of 25-sets of three pictures, had been used since the
nineteenth-century, primarily as an intelligence test to measure consciously
controlled rational thinking. The subject was to arrange the pictures in any
sequence that made sense and to write a brief explanation about each picture to
explain its arrangement. The results were expected to indicate social orientation,
optimism-pessimism, and the relative strength of thinking and thought to assist in
furnishing objective criteria for the effective handling of the problem created by sex
deviates. In addition, responses given by the criminals were believed to correlate
with significant features of mental illness.
350
Out of Mind, Out of Sight
127
Dorce Fulghan Dean 194.? Photo courtesy of the Florida State Hospital.
An Inside Look at Psychiatric Nurses Training
By the 1950s, the hospital offered Psychiatric Nursing Education to nursing
students from outside programs. Attending classes at the Chattahoochee hospital
campus in 1954 was Jackie (Hogarth) Humes, a nursing student studying for her
Registered Nurse license from Riverside Hospital in Newport News, Virginia.
During her three months at the hospital, she lived in a dormitory on the campus with
nursing students from other facilities and was assigned to various wards in order to
gain knowledge of different psychiatric disorders, how they affected the patients,
and what current medications and therapies proved effective.
Humes explained that the students were taken on tours of areas they were
not allowed to work in, such as the Surgical Ward. While she didn’t observe any
surgeries, she was told lobotomies were sometimes performed. Other tours included
the ‘Back Wards’ where patients too severely mentally disabled to function in
society were housed as well as the ward for the criminally insane. In the latter,
Humes was introduced to a patient called ‘The Stomper,who acquired her name
because she had physically stomped 13 people to death. Isolated in an individual
cell, “The Stomper, could only be viewed through the iron bars that surrounded
her.
Sally J. Ling
128
Part of Humes training involved her assistance in the administration of
electroshock therapy. To prepare for the therapy, 20 to 30 patients per session were
lined up in a long hallway with their heads facing the center of the hall. The
students, called staff assistants, were divided into teams of six with each team
surrounding a patient’s bed. Because the shock caused an immediate grand-mal
seizure, their job was to hold the patient in place to prevent jerking movements
during the procedure that could result in head injuries or broken bones from hitting
furniture or other objects. Just before the shock was administered, an assistant
placed a “bite block” in the patient’s mouth to prevent him or her from biting or
severing the tongue or lacerating the inside of the cheeks. Once staff and the bite
block were in place, the doctor determined the strength and duration of the electrical
current, set the machine accordingly, and an RN placed the paddles on the patient’s
temples.
As soon as that patient stopped seizing, the team moved past teams
stabilizing other patients and onto the next patient in line for therapy. After the
shock, the patient would be drowsy, inactive, and sometimes disoriented 24 to 48
hours. Another side effect was brief loss of short-term memory.
When nursing students were on rounds, the instructors stressed caution and
emphasized the practice of proper protocol. For instance, to administer medications,
nurses escorted patients to the nurse’s station; and, although at times nurses were
allowed to take medications to a patient, they could do so only if a staff person
accompanied them. Another protocol observed involved the use of keys that were
only to be visible when opening or closing a door. While this became routine,
Humes recalled that hearing locks click behind her took quite an adjustment.
Psychiatric nurses training also included the interaction of students with
patients in the sitting rooms where the nurses were required to write a paper
regarding the diagnosis, treatment, medications, response, status, and prognosis for
discharge of a patient. During these times, Humes observed a number of patients
suffering from a variety of mental illnesses. One of these was a German woman
who, to the casual observer, appeared normal. On occasion, however, she would
hear voices. Going to the window, she would point out individuals (persons invisible
except to her) who were using the radio connected to the window screen (also
invisible except to her) to spy on her and plan her murder.
Other patients observed were in catatonic states. Humes said these patients
were lifted from their beds and taken to the sitting room where they remained for the
day in whatever position the patient assumed when placed in the chair. Restraints
Out of Mind, Out of Sight
129
Student nurses attend school. Photo courtesy of the Florida State Hospital.
were used to prevent them from falling, and pads were placed beneath both the
patient and chair to catch urine and feces until they could be taken for clean-up at
regular intervals.
Humes did not become a psychiatric nurse because she felt she did not
possess the ability to deal with the hopelessness of the patient not being returned to
family or society as a normally behaving individual.” While she did observe many
sad situations at the hospital, she was unaware of patients being beaten, burned,
starved, imprisoned in dungeons, or otherwise abused as previously reported.
On a humorous note, Humes relayed an incident her family encountered
when arriving to pick her up at the hospital one day. As they drove toward the
parking area, they observed a male soldier dressed in khaki uniform wearing high
heels, makeup (including lipstick), and carrying a lady’s purse on his arm.
351
Sally J. Ling
130
Case Histories
The following case histories show the variety of patients who were admitted
to the Florida State Hospital at Chattahoochee during the 1950s:
Court Admission
Miss Dohna Lousie Bushong, an indigent from Okaloosa
County, admitted on November 2, 1959.
Her mother Mrs. Mabel Lousie Clements filed the petition
for inquisition of incompetency of this 16-year-old girl on 10/2/59,
stating that the nature of her disability was “mental.” She was put
before a committee of examination consisting of Dr. Robert W.
Wienecke, Dr. Arthur W. Brown, and Ronald C. Bounous. On
October 22, the committee determined that Dohna was incompetent,
the apparent cause being Adolescent Situational Reaction (Turmoil
State), which is chronic. Her propensities were: impulse acting out
though she did not require mechanical restraint. Relatives were
legally responsible for her support, but they were not able to pay in
full for her treatment at Florida State Hospital. She was ordered to
the facility on 10/29/59.
352
Admission by Certification
Mrs. Evelyn Lucile Boone, from Gadsden County.
Admitted on November 14, 1959.
Lucile, 49, lived in Chattahoochee. Her husband petitioned
for an inquisition of incompetency on 11/12/50, stating that her
disability was mental incompetency (his address was FSH
Chattahoochee, and it is inferred that he worked at the hospital).
The examining committee reported on 11/13/5, that Lucile was
incompetent, the apparent cause being extreme depression. The
particular hallucinations were: she wanted death, was no good, and
would never be well. Considered a danger to herself, she required
mechanical restraint to prevent self-injury or violence to others. She
was destitute, as was her family.
353
Out of Mind, Out of Sight
131
Upon recommendation of the examining committee, Evelyn
was declared temporarily incompetent. They felt, however, that
through specialized care and treatment, she would speedily be
restored to competency. She was ordered on 11/13/59, to be
certified to the director of mental health for admission to the state
hospital for intensive care, treatment, and observation for a period
not to exceed six months.
Criminal Court Admittance
Mrs. Lucille Mary Alice Barnett, from Hillsborough
County, was admitted on November 25, 1959. She was brought in
by Sheriff Henry B. Knabel.
On 7/3/58, courts charged Mary Alice with second degree
murder. The trial was held before Honorable L.A. Grayson, and
Mary Alice was acquitted by reason of insanity. Based on the
testimony of three doctors, the court ruled that she should not be
discharged and that allowing her to remain at large would be
considered by these doctors as manifestly dangerous to the peace
and safety of the public. The court ordered that she be committed to
the Florida State Hospital until further order of the court, and that
she not be released from the hospital without consent of the court.
354
Inquisition of Incompetency
James G. Burleson, from Bay County, was admitted on
November 30, 1959.
Mr. Lee Roy, father of this 16-year-old boy, petitioned for
an inquisition of incompetency on 11/16/59, stating that the nature
of his son’s disability was mental disorder. After examination on
11/17/59, the committee found James incompetent by reason of
acute compulsory sexually oriented psychosis. Mechanical restrains
were required to prevent self-injury or violence to others.
355
Sally J. Ling
132
Mr. James Alex Barnhill, an indigent from Sarasota County,
was admitted on September 9, 1959.
On 8/20/59, three citizens, Floyd G. Bowers, Jr., Ernest L.
Agnew, and William M. Boley, filed an Inquisition of
Incompetency alleging that this 51-year-old man’s disability was
mental illness. On the same date, the court entered an order to
summons a committee to examine Mr. Barnhill. The order claimed
that the disability was mental illness: disturbing the peace,
drunkenness, and attempts to kill three policemen. The committee
determined that James was incompetent with the cause being mental
illness: chronic organic brain syndrome, cause undetermined. While
Mr. Barnhill was considered homicidal, he did not require
mechanical restraint.
356
New Therapies Introduced
While the decade of the 1950s opened with new enthusiasm for what lay
ahead in the area of psychiatric treatment, ECT and insulin shock therapy were still
being used as primary responses in treating the mentally ill. Just around the corner,
however, were two new therapiesmilieu therapy (therapeutic community) and
psychotropic drugs. According to Grob, Milieu therapy had much in common with
early nineteenth-century moral treatment, namely, the belief that the environment of
the asylum could assist in the treatment of mentally ill persons and thus facilitate
their release into the community.”
357
Implementing this new therapy required a shift in philosophy, and while
some hospitals experimented with programs such as abolishing locked doors and
fences, and others included daytime care where patients returned to their homes in
the evening,
358
most hospitals weren’t quite ready to embrace such radical change.
Change was in the wind, however, and like the introduction of shock treatments and
lobotomies of previous decades, European physicians led the way.
Discovering a Miracle Drug
Looking for a way to reduce surgical shock in his patients, French surgeon
Henri Laborit used antihistamines (a compound used to fight allergies) to counteract
the chemicals in the brain that caused the shock. Administering strong doses, he
Out of Mind, Out of Sight
133
discovered that his patients seemed less anxious about their impending surgery with
some even showing marked apathy. It struck Laborit that the effect of these drugs,
especially one called chlorpromazine (trade name Thorazine), might have
applications in psychiatry. While the psychiatric community had never used drugs
on the mentally ill and continued to avow the use of shock treatments, Laborit
doggedly touted his belief that the drug had great potential.
Psychiatrist Pierre Deniker heard of Laborit’s findings and tried
chlorpromazine on several of his most agitated and uncontrollable patients. He
reported stunning results: “Patients who had stood in one spot without moving for
weeks, patients who had to be restrained because of violent behavior, could now
make contact with others and be left without supervision.” Another psychiatrist
reported: "For the first time we could see that they were sick individuals to whom
we could now talk."
359
Meanwhile, in the U.S., Smith Kline, an American drug company, was
looking to expand its product line. Purchasing the rights to chlorpromazine in 1952
from the European company Rhône-Poulenc, Smith Kline introduced the drug into
the American market. Even though word had spread of the drug’s previously
successful use by Deniker on psychiatric patients in Europe, its debut remained
simply that of an anti-vomiting treatment.
Unsuccessful in its attempts to convince university psychology departments
and medical schools to test the new drug, Smith Kline persuaded Deniker to come to
the U.S. to help promote the product. Persuading physicians in private practice to
use the new drug fell dreadfully short of expectations, but state governments were
far more open when they learned that treating mentally ill patients with the new drug
could save money.
Testing soon commenced in state institutions with miraculous results
being reported on television and in other news media. Patients rapidly adjusted to
hospital society and life, there was an absence of fear of such drastic treatment as
electroshock, and there was the tendency of the tranquilizing drugs to make patients
much more willing to participate in psychotherapy.
360
These results prompted the
U.S. Food and Drug Administration to approve chlorpromazine in 1954, resulting in
its rapid spread throughout the country. The use of insulin shock (only on select
cases) and ECT waned, and patients who once had no hope were now being
discharged in record numbers.
361
Sally J. Ling
134
One of the practical aspects of the drug was the decrease in the number of
injuries patients inflicted upon themselves and in the destruction to hospital
property, including linens, mattresses, and clothing. This and other drugs weren’t the
only reason for improvement, however, as the combination of additional psychiatric
staff played a significant role.
362
For all its benefits, Thorazine was not without its side effects, some that
mimicked the uncontrollable shaking of Parkinson’s disease; still, its astonishing
benefits began a flood of research and development of new psychotropic drugs,
resulting in the virtual disappearance of psychosurgery. Grob noted that: The
simultaneous development of milieu and drug therapies also helped to blur further
the traditional schism between biological and psychodynamic psychiatry, and thus
appeared to anticipate the reintegration of psychiatry into medicine.”
363
For all the promise milieu and drug therapies brought to state institutions,
commitment procedures, institutional practices, and daily care of patients lacked the
same advancement. It would take decades, along with a patient named Kenneth
Donaldson, to untangle the web of apathy.
Aerial view of the Florida State Hospital 1954. Photo courtesy of the Florida State Hospital.
Out of Mind, Out of Sight
135
Kenneth Donaldson Sent to the Florida State Hospital
Born in 1908, in Erie, Pennsylvania, Donaldson briefly attended Syracuse
University, married, and had three children. Believing that people made derogatory
comments about him behind his back therefore rendering him the victim of slander
and harassment, he was committed to Marcy State Hospital for four months. Later
divorced and moving from town to town, in 1956, he was admitted to Philadelphia
General Hospital where he was treated for paranoid schizophrenia. After his release,
he traveled to Largo, Florida, where he visited his parents.
364
It was there his
incredible saga beganone that lasted fifteen years.
It was December 10, 1956, when Kenneth Donaldson, 48, answered a knock
at his parent’s door. On the other side, law enforcement officials presented him with
papers signed by Jack White, Pinellas County Judge. The document, initiated by his
father William Donaldson, who believed his son to be potentially dangerous, called
for an “Inquisition of Incompetency.The document stated that Kenneth Donaldson
was exhibiting signs of a persecution complex with “increasing signs of paranoid
delusions.
365
He was ordered to the Pinellas County Jail.
Donaldson’s Saga Begins
While in jail awaiting his hearing, Donaldson met Mable, a woman who
occupied a cell at the far end of the facility. Her story, like so many others, exposed
the gross injustice of the then existing laws that allowed individuals to be
incarcerated for unacceptable, yet innocuous, behavior.
According to Donaldson, Mable had sunbathed in the nude in her own back
yard that was shielded from her neighbors’ eyes. Yet, just knowing she was doing it
was apparently enough to justify her arrest. She was first sent to the St. Petersburg
jail where she was confined in a ‘strip cell’ without clothes, food, or water, and
where she caught urine in her hands to drink. Then, without a hearing, she was sent
to Chattahoochee.
366
In another case, the police detained and searched the car of Aaron, a
locksmith, who had moved to Florida from New York. During the search, officers
found an unlicensed gun that Aaron claimed he needed for protection. Despite his
protests, he was taken to the Pinellas county jail. Once there, his objections became
so raucous and persistent the police suggested he belonged in Hollywood State
Hospital rather than jail (Hollywood State Hospital, known officially as the South
Sally J. Ling
136
Florida State Hospital, was part of the state hospital system). Now considered a
criminal, he, too, was sent to Chattahoochee.
367
Donaldson was housed in the Detention Ward of the Pinellas County Jail for
several weeks prior to his hearing. While there, he underwent a competency hearing,
engaged in numerous verbal and written appeals for his release, and was involved in
other discussions regarding his sanity and unlawful confinement; but, in the end, he
was sent to the Florida State Hospital at Chattahoochee where he was admitted on
January 15, 1957.
368
His state of mind at time of incarceration included delusions of
being persecuted and claims that “rich Republicans” were poisoning his food.
Doctors at Chattahoochee listed his diagnosis as “schizophrenic reaction, paranoid
type (Psychotic).”
369
Donald said of his situation: “In three months, I had come from the
supposedly free streets of Pinellas County to Coventry. I had appealed for justice to
many people. I was as important as a fly on a basketball hoop.
370
During his fifteen years at Chattahoochee, Donaldson tenaciously tried to
convince doctors, and anyone else who would listen, that he was not insane and had
been denied a writ of habeas corpus. (A writ of habeas corpus is a judicial mandate
to a prison official ordering that an inmate be brought to the court so it can be
determined whether or not that person is imprisoned lawfully and whether or not he
should be released from custody. The petition must show that the court ordering the
detention or imprisonment made a legal or factual error.)
371
Eventually, Donaldson engaged the services of a competent attorney and
sued several prominent doctors at Chattahoochee. Events leading up to that lawsuit
and results of the hearing will be discussed in subsequent chapters, as this case had a
profound effect on the mental health care system in Florida and throughout the
country.
Dr. William DeWitt Rogers Appointed Superintendent
Dr. William DeWitt Rogers was one of the most dedicated and influential
men to serve at the Florida State Hospital. A native of Kensington, Georgia, he
graduated from the Medical College of Georgia in Augusta in 1933, and began his
practice at the Florida State Hospital in 1934. In 1940, he became clinical director
and served in that capacity until 1950, when he was named superintendent. He later
Out of Mind, Out of Sight
137
Dr. W.D. Rogers, Superintendent, and J.C. Gissendaner. Photo
courtesy of the Florida State Hospital.
became the first director of Florida's Division of Mental Health in 1962, and served
there until his retirement in 1974.
During his service with the Department of Children and Families, he
established Florida's first statewide community mental health system and led the
effort to establish mental health treatment programs for children and the elderly
statewide. During his tenure as Director of the Division of Mental Health, he was
responsible for the administration at both the Florida State Hospital at
Chattahoochee and G. Pierce Wood Memorial Hospital in Arcadia. Additionally, he
was responsible for the development, implementation, and administration of the
South Florida State Hospital in Hollywood/Pembroke Pines and Northeast Florida
State Hospital at Macclenny. He was involved in the planning and first phase
construction of the Florida Mental Health Institute at Tampa and the establishment
of an Evaluation Center at Gainesville for mentally ill offenders.
372
Sally J. Ling
138
For his service, Rogers received numerous awards including the Allen
Morris award and the Most Effective State Administrator Award during 1957,
Meritorious Public Service Award, National Association for Mental Health
Distinguished Service Award, Florida Rehabilitation Association Professionalism
Award, and Mental Health Association of Florida Distinguished Service Award.
Along with his wife Mary and his two sons William DeWitt Rogers, Jr. and
John Bowen Rogers, he lived in what is now the William DeWitt Rogers
Administration Building. The Rogers family, the last to use the structure as a
residence (1950-1961), moved into their new home when the Florida Legislature
subsequently appropriated funding for its construction on hospital grounds. Their
former home was converted into the administration building. (See Appendix for an
interview with Mary Rogers.)
On September 14, 2007, over 100 people , including legislators, judges,
family, and friends of the late William DeWitt Rogers gathered outside the
administration building when Governor Charlie Crist dedicated the building in
Rogers' honor. (The William DeWitt Rogers Administration Building currently
houses hospital administration and is commonly referred to by hospital employees
as the "White House." See page 10.)
373
State Hospital System Expands
As Florida’s population grew, the Legislature realized that the Florida State
Hospital system needed to expand in order to alleviate overcrowding at
Chattahoochee and to become more accessible to patients throughout the state. At
the same time, they realized the need for a responsible group to oversee the system.
The Division of Mental Health began functioning in July 1957. It was charged with
the supervision of all state hospitals for the mentally ill.
374
Out of Mind, Out of Sight
139
Chapter Photo: Outside the Administration Building at the South Florida State Hospital,
Hollywood, Florida. ca. 1960. Photo courtesy of the Francis Pou Collection.
Chapter XI
Two New State Hospitals Added
South Florida State Hospital/Hollywood
Hollywood, Florida, (between Fort Lauderdale and Miami) was tapped as the first
city where a new South Florida State Hospital would be built under the Regional
Hospital Plan because of the area’s rapidly expanding population (1,250,000 in
1956).
Like the hospital in Arcadia, the South Florida State Hospital was built
where barracks once stood on an old World War II military baseNorth Perry
Airfield. The U.S. Navy originally constructed the airfield in 1943 for use as a
satellite training facility of the Miami Naval Air Station. North Perry serviced flight-
training activities until the end of the war when it was decommissioned. Broward
County acquired the land in 1950. The airfield was renamed North Perry Airport and
continues to operate today as a general aviation airport dedicated exclusively to
private and light-plane business activity.
375
Sally J. Ling
140
The South Florida State Hospital covered three hundred acres west of the
airport and was constructed at a cost of over $5 million. The hospital was activated
on March 1, 1957, when 20 patients arrived from Chattahoochee while another 11
patients were transferred from the G. Pierce Wood Memorial Hospital in Arcadia.
Also admitted were patients from the surrounding counties of St. Lucie, Martin,
Palm Beach, Broward, Dade, Monroe, Collier, and Hendry.
376
Arnold H. Eichert,
M.D., became its first superintendent. (With the re-zoning of Hollywood’s city
limits in 1960, the hospital became located west of Hollywood in the newly created
city of Pembroke Pines.)
Similar to the overcrowding experienced by the hospital at Chattahoochee,
by the end of 1958 the Hollywood hospital housed 572 patients although current
buildings were designed to care for only 484. There was some good news though.
Because the hospital was located in an area with a large and growing population and
was close to the University of Miami’s teaching hospital, the South Florida facility
was able to fill its available positions with well-trained and capable personnel. In
addition, the hospital established teaching programs at the University of Miami
hospital in a variety of disciplines, including psychiatry.
377
A number of young adult patients necessitated the inclusion of schoolwork
into the hospital curriculum. Textbooks and school supplies were donated, and a
volunteer part-time teacher assisted with the teens education. To encourage female
patients to take a personal interest in their appearance and overall wellbeing, a
Charm School was added to the facility. Over 200 female patients benefited from
hearing guest speakers present a variety of topics on personal hygiene and social
etiquette. They also enjoyed the use of donated cosmetics and other supplies. To
better prepare the young men and women to deal with obtaining employment once
they were discharged, a business school was established with donated typewriters
and office equipment.
378
The hospital operated under the state’s care until the late 1970s, when
patient abuse, sexual misconduct by state employees, and lax security led to an
investigation by a Broward County grand jury and the U.S. Department of Justice.
The investigation branded the hospital a “warehouse for the mentally ill” with the
grand jury describing it as a “‘loosely knit conspiracy’ to turn the hospital’s staff
into a ‘haven for homosexuals. . .’” The conditions were so bad that one ward was
put under the oversight of a Broward County judge.
Shortly thereafter, Governor Bob Graham recruited Robert Burton, an
administrator with Jackson Memorial Hospital in Miami, to run the facility. Not
Out of Mind, Out of Sight
141
wanting to become a state employee, Burton formed Amerimanage, Inc., and
received a two-year $1.1 million management contract in which an 11-person team
oversaw the 1,200 patients.
The contract was very controversial. First, it gave a private firm control of a
state institution; and second, the contract was awarded without competitive bidding.
After the first year, however, a grand jury report noted that, while the hospital was
“far from what it could be, or should be,” it had improved dramatically. This
prompted the state to renew the Amerimanage, Inc. contract and even to propose a
contract to help run the Northeast Florida State Hospital at Macclenny.
379
Amidst reports of group nudity, neglect, staff overload, and patients living
in terror, the state regained control of the hospital in 1987 as a cost cutting
measure.
380
Then, in 1993, under threat of a class action lawsuit, the state announced
plans to shut down the 349-bed hospital, citing that it would be a multimillion-dollar
investment to bring the institution up to higher standards.
381
The South Florida State Hospital continued to operate with state employees
until November 1998, when the state turned the hospital over to Atlantic Shores
Healthcare, later renamed GEO Care. As part of the company’s contract with the
Department of Children and Families, a new state-of-the-art hospital was built in
2001. Currently, the Boca Raton-based GEO Care, a mental health subsidiary of the
GEO Group, Inc., is under contract with the Department of Children and Families
(DCF) for the management and operation of the hospital.
382
Northeast Florida State Hospital/Macclenny
In 1955, the state legislature authorized the construction of the Northeast
Florida State Hospital (NEFSH) at Macclenny, Florida, 35 miles west of
Jacksonville. It wasn’t activated, however, until 1959, when the necessary funds
were appropriated. The purpose of the hospital was to relieve overcrowding at
Chattahoochee and to service patients in the northeastern portion of the state. J.T.
Benbow, M.D., then clinical director at the Florida State Hospital at Chattahoochee,
became its first superintendent. Similar to the Hollywood facility, Northeast Florida
State Hospital was able to attract and retain qualified staff because of its proximity
to a large population in Jacksonville.
On August 17, 1959, 74 patients from Chattahoochee transferred to
Macclenny that had the capability of 475 beds.
383
In its first 10 months of operation,
Sally J. Ling
142
the hospital admitted 879 patients; and by 1960, it had a population of 363.
384
Wards
were small, with no ward containing over 38 beds, and patients enjoyed the facility’s
open hospital policy that allowed them to have as much freedom on the grounds as
possible, based upon their mental condition.
385
Similar to patients at Chattahoochee and Arcadia, patients at the Hollywood
and Macclenny facilities were segregated by gender and race with each group
having its own kitchen, dining room, and therapy facilities.
386
Each of the new
hospitals was mostly self-contained, with its own support services, amenities, social
service department, and variety of therapy departments.
In March 1963, the hospital sent a registered nurse and a psychiatric aide to
the Veterans Hospital in Tuscaloosa, Alabama, to attend the formal training course
in “remotivation,” a program designed to inspire patients to get well. The course
sponsored by Smith, Kline & French Laboratories was presented under the auspices
of the American Psychiatric Association. When the two staff members returned,
they started a training course at the hospital, and, in June 1963, the program began
with a total of 47 aides and two RNs. The department took over an area that was
once a small canteen and converted it into a combination kitchen and library
equipped with kitchen equipment, a record player, and books. The remotivation
aides conducted two sessions a week with patient groups for a period of six weeks.
After consultation with psychiatrists and other team members, they then made
recommendations for selected patients to transfer to group therapy.
387
This program, which was originally designed to meet the need of a geriatric
as well as a chronically withdrawn group of patients in a State Hospital, was
expanded and modified to suit the hospital’s needs, and eventually became the
forerunner to formalized group therapy that introduced patients into group
interaction much more quickly.
388
In 1987, Governor Bob Martinez proposed turning the Northeast Florida
state hospital into a prison, a move that would necessitate the release of hundreds of
mental patients into the community. Legislators from across the area vehemently
opposed the plan. These included Representatives Corrine Brown (D-Jacksonville),
who called it, “. . . the worst thing I’ve ever seen, and Representative Mike
Langton (D-Jacksonville), who remarked, “That is a high-security prison for the
mentally ill. They aren’t the kind of people you can release.”
389
Eventually, the
proposal died.
Out of Mind, Out of Sight
143
Three years later, safety concerns at the facility surfaced prompting the state
to provide an additional $4.2 million to add 120 employees. Treating 575 patients at
any given time, the Northeast Florida State Hospital was the largest of the three state
hospitals that treated mentally ill patients committed through civil court
proceedings; yet, with 1,130 employees, it ranked last among the institutions in
number of staff. The addition of 10 psychologists and 10 nurses, along with
additional staff, was intended to reduce a patient’s length of stay which at the time
averaged around 18 months.
390
In the year 2000, the Northeast Florida State Hospital was the recipient of
the Governor's Sterling Award for Organizational Performance Excellence. It has
also been awarded numerous Davis Productivity Awards, and achieved accreditation
from the Commission on Accreditation of Rehabilitation Facilities (CARF).
391
In an effort to save money, privatization of the hospital by GEO Group was
under consideration in 2006. Over the next couple of years, however, opposition by
Florida legislators, Baker county leaders, as well as hospital staff and residents
picked up momentum, and by 2009 all negotiations were abandoned.
392
Today, Northeast Florida State Hospital serves Children and Families in 30
Florida counties by providing continuous service to persons with severe and
persistent mental illness. With 633 beds, it is the largest state-owned provider of
psychiatric care and treatment to civilly committed individuals in Florida and is the
largest single employer in Baker County. Referrals are based upon community and
district priorities for admission.
393
Chattahoochee Still in Dire Need
Although the new hospital at Macclenny afforded some much needed relief
to the hospital at Chattahoochee, the admission rate at Chattahoochee experienced
no appreciable decline. This was explained by the fact that the relief they expected
was offset by increased admissions due to Florida’s expanding population.
394
Steady
admissions weren’t the hospital’s only problem. Maintaining an adequate medical
staff continued to plague the institution, both in numbers, and in the quality of
training and adaptability to institutional standards. This was attributed to the fact
that the supply of physicians and psychiatrists had not kept pace with demand.
395
Sally J. Ling
144
Park Trammell Building. Photo courtesy of the Florida State Hospital.
Admissions by Certification
In 1959, the legislature authorized admissions by order of certification. This
allowed for the temporary hospitalization of mentally ill patients not to exceed six
months. If more than six months was needed, commitment by the County Court was
required. In addition, no longer were those who were senile, addicted to drugs or
alcohol, intellectually challenged, epileptic, a nonresident, or those subject to
pending criminal charges allowed to be certified to a state hospital.
396
While this helped reduce new admissions, unfortunately, it left those who
fell into one of these groups who were already committed to state hospitals,
especially the aged, vulnerable to longer stays. Housing a large number of elderly
non-mentally ill patients was just one of the problems plaguing the Chattahoochee
institution. Once again, rumors of patient mistreatment reached the Legislature, and
on February 1, 1961, an investigation of the allegations began.
Out of Mind, Out of Sight
145
Chapter Photo: William Dewitt Rogers Administration Building. Photo courtesy of the Florida State
Hospital.
Chapter XII
Investigation and Changes
In 1961, the Committee on State Institutions was charged with conducting a
thorough study of the allegations of patient mistreatment at the Florida State
Hospital at Chattahoochee. Over the next three months, the institution was reviewed,
doctors, attendants and patients gave statements, and recommendations were made;
however, the final portion of the studyinvestigating the accuracy of the
statementsnever took place. This, the Committee believed, was the responsibility
of the executive branch, not the legislative branch, so the Committee made all
reports available to the Governor’s office so it could further investigate the
allegations. There is no indication this ever occurred.
397
The Investigation
The Committee report indicated that, in general, the hospital had made great
improvement, noting that the overall atmosphere was relaxed, the wards spic and
span, no overcrowding existed and the doctors and nurses were able to provide
Sally J. Ling
146
adequate care to the patients. They did cite, however, the complete obsolescence of
the White Male and White Female Departments as possible contributing factors to
the allegations of patient mistreatment. The buildings housing many of these
patients were original to the arsenal (completed in 1839) and contained such
outmoded facilities as “toilet troughs” that were used in World War I. The main
concern, though, was with the white Male Department, as this was where most of
the complaints originated.
398
In this department, 1,000 patients were distributed among 10 crowded
wards, ranging from 82 to 192 patients each. There was virtually no segregation as
to type of mental illness, age, health, or charge patient (35 percent had been charged
with a crime). Thus, the feeble elderly were housed among teen-agers, psychopaths,
and criminals, ranging from forgers to rapists and even murderers.
Because criminals, some quite violent, were mixed with non-charge
patients, attendants believed their energies needed to be focused on maintaining
order among the charge patients rather than aiding and caring for the needs of all the
patients. This led to the implementation of strict security, more than what would
normally be required. In light of this, the Committee concluded that the wards were
operated more like detention facilities for inmates than hospital wards for the sick.
They recommended that charge patients be isolated from the non-charge patients
and that current structures be remodeled or replaced.
399
It wasn’t until the middle of
following decade, however, that a forensic unit to house the criminally mentally ill
was finally built.
Complaints from patients, corroborated by the testimony of dozens of
attendants, included: stolen packages, loss of mail, lack of medical treatment and
occupational therapy, teasing, physical violence such as choking and beating,
prolonged confinement in solitary “strip cells,and the use of punitive wards such
as “the squad.”
Strip cells consisted of solitary unfurnished cells that were used to isolate
a patient who proved to be of danger to himself or others. The squad, on the other
hand, was a portion of Ward 8 that was set aside so attendants could more closely
supervise those who were highly disturbed or trying to escape. Testimony indicated,
however, that it was used for much more than that. These two areas alone were
responsible for a number of suicides.
400
Out of Mind, Out of Sight
147
Testimony
Delbert Evans, a former patient of the hospital who lived in Tampa at the
time of the study, testified before the committee. Referring to himself as a “victim
rather than a patient, he said the authorities had carte blanche to do “anything under
the guise of treatment no matter how inhumane.” He went on to tell the Committee
he had personally witnessed patients being given shock and ice pack treatments or
put in steel hand cuffs, some up to six months at a time, not as treatment but because
they had escaped or tried to do so. He also said that the squad was where most of the
beatings and brutal treatment occurred.
One former patient Guy W. Hoagland even wrote a letter to President John
F. Kennedy to complain about the brutality, lack of medical treatment and
rehabilitation programs, unpalatable food, and violation of Federal laws regarding
mailing privileges for inmates in state institutions. He concluded that widespread
graft had permeated the hospital administration.
401
Other non-charge patients expressed feelings of total despair over ever
being released from the institution. These were patients who felt trapped because
they did not have anyone on the outside to accept responsibility for them, so they
continued to languish in the facility for years, even though they were able to be
treated or cured and eligible for release.
402
Thirty-three white and black, male and female patients gave testimony to
the Committee, as did 18 attendants. Many of the attendants were reluctant to speak,
fearing physical retribution or the loss of their jobs. Because of this, Committee
Aide John J. Parker met with attendants off hospital grounds where they more freely
shared their experiences. Those that gave statements indicated that the low morale
among attendants was due, in part, to believing they were receiving only subsistence
wages. The average take home pay of an attendant at the Florida State Hospital was
$1,700 per year whereas other institutions, such as the Appalachee Correctional
Institution, paid their attendants $600 to $1,200 more per year. This forced most
Chattahoochee attendants to supplement their incomes with outside jobs, some
working on area farms.
403
Attendants seemed well aware of patient mistreatment, with almost all of
them having either heard of or having witnessed firsthand the common restraint
technique of choking out a patient. Not surprisingly, few confessed to having used
it themselves. They did, however, describe some of the conditions at the hospital
that led to such abuse.
Sally J. Ling
148
Jeff R. Spooner, an attendant, explained that he felt there weren’t enough
attendants to look after the needs of the patients and that the hospital was “one big
mass of family ties,” leading to the opportunity for patients to be easily framed. He
had knowledge of attendants who permitted homosexual acts among the patients,
times when medical attention was withheld, and intimated that administrators,
including Dr. Rogers, seemed disinterested in addressing these issues.
Attendant Alvin Mercer addressed the fact that patients weren’t getting the
treatment they deserved, citing his observation that there were some patients who
hadn’t seen a doctor for months. He also noted that there was neither a doctor nor
nurse on the floor after 3:00 p.m.
The doctors assigned to the white Male Department were Dr. Wilfred J.
Char and John Gumanis. These two doctors, along with the attendants, were entirely
responsible for the care and treatment of the 1,000 patients. No nurses were assigned
to the ward.
Both physicians felt overwhelmed by the workload and recommended hiring
another doctor and adding nurses. They also recommended that charge patients
(patients charged with a crime) be removed from the hospital. Aside from the fact
that Gumanis noted some patients had not been outside in three months, neither
doctor indicated they had knowledge of physical abuse of the patients.
404
Recommendations
One of the most important recommendations made by the Committee was
for the establishment of a Personnel Department and the hiring of a personnel
director who would be directly responsible to the hospital superintendent. This
department would establish job descriptions and hire employees based on
qualifications and experience. Other recommendations included: establishing pay
scales, removing charge patients from the hospital, adding more attendants, male
nurses and medical assistants, establishing an occupational therapy program,
refurbishing antiquated facilities, and segregating patients by conditions of health.
405
Aged Patients Overwhelm System
By 1962, patients aged 65 and older represented 26.1 percent of patients in all state
hospitals in Florida, an increase of over ten percent over 1952.
406
By 1964, that
number had risen to 27.6
407
percent, as the hospital increasingly became the
Out of Mind, Out of Sight
149
Pearl Trammel (left front), black female Aides, 192?. Photo courtesy of the Florida State Hospital.
repository for those suffering from senile brain disorder—Alzheimer’s and
dementia-related conditions. (Dementia is a continually declining disease where no
rehabilitation is possible. Some dementia symptoms can be caused by medications
that can be adjusted, but dementia is a deteriorating disease.)
Like many Floridians, Robert B. “Bob” Williams, former Florida State
Hospital administrator (1978-1980, 1981-1987, 1993-1999), had a grandmother who
suffered from Alzheimer’s. While the family cared for her at home for many years,
eventually they were no longer able to do so, and the family placed her in the
Florida State Hospital because there was, simply no alternative for people in her
situation.
408
She died in the hospital in 1967.
To counter this explosion of elderly into the mental health care system, a
pilot program was initiated by the State Welfare Department to place the elderly in
approved Foster Homes.
409
Unfortunately, the program didn’t catch on. Records
indicate that from 1962-1964, only two patients were released on Foster Home
Care,
410
but the lack of success didn’t dampen the state’s increasing emphasis on
rehabilitation and returning patients to the comfort of their homes.
Sally J. Ling
150
White male yard, 1950s. Photo courtesy of the Florida State Hospital, Florida State News
Bureau, Tallahassee.
With 30.5 percent of the patients 65 years or older by 1966, the State
Welfare Department assigned 23 welfare personnel to the hospital in hopes of
reducing the elderly population through suitable placement in select nursing
homes.
411
In addition, amendments to the Social Security Act in 1965 made it
possible for assistance payments to persons 65 or older residing in mental hospitals.
Overseeing this program were the new employees of the State Welfare
Department.
412
The Courts and Medicare
During the 1960s, courts around the country began to hear legal cases
relating to the mentally ill. In response to questions presented during these
procedures, “Courts defined the right to treatment in the least restrictive
Out of Mind, Out of Sight
151
environment; shortened the duration of all forms of commitment and placed
restraints on its application; undermined the sole right of psychiatrists to make
purely medical judgments about the necessity of commitment; accepted the rights of
patients to litigate both before and after admission to a mental institution; and even
defined a right of a patient to refuse treatment under certain circumstances.”
413
With the passing of Medicaid in 1965, states shifted care of elderly persons
with behavioral symptoms from mental hospitals to chronic care nursing facilities;
yet, many of the facilities had no psychiatric care, resulting in an increased death
rate. Nevertheless, this proved to be a popular alternative because the federal
government incurred a large percentage of the cost of care.
414
By the late 1960s, the population of geriatric patients at Chattahoochee and
other state hospitals in Florida began to reach critical levels. To deal with the
problem, a special Task Force on Geriatrics was commissioned by the Secretary of
State, Chairman of the Cabinet Committee on the Division of Mental Health. The
task force was to work with the Division of Mental Health and State Department of
Public Welfare to study the situation in detail and propose a solution.
Operation Hope
The Task Force suggested “Operation Hope in 1968, a pilot project
designed to achieve two goals. First, it was to reinforce the premise that most
geriatric patients could be better cared for in nursing homes, boarding homes, foster
homes, and sometimes, independent living in their own homes. Second, it was to
devise an innovative and improved statewide system of evaluating geriatric patients
in their local communities in order to eliminate unnecessary admissions to the State
hospitals.
415
While it was anticipated that Operation Hope would reduce overcrowding in
state hospitals, the bigger hope was that this project would eliminate those who, in
the past, were admitted with physical ailments (epilepsy, senility, etc.), and only
admit those who were actually suffering from some type of mental illness.
416
Financing for the project was approved by the Board, and up to $100,000 was
budgeted from the Division of Mental Health Trust Fund (monies from existing
revenues allocated to the Division of Mental Health and the Welfare Department).
The joint project by the Division of Mental Health and the Department of
Public Welfare located in Orange, Seminole, Brevard, Osceola, and Volusia
counties, limited the program to the 100 persons already in the state hospitals or
Sally J. Ling
152
those whose commitment proceedings had already been initiated. In 1969, there
were 78 referrals, 36 complete placements, and nine ready to be placed.
417
Florida Division of Mental Health
By authority of the 1965 Florida Legislature, the Division of Mental Health
with Dr. William Rogers at its helm assumed the responsibility for the Community
Mental Health programs formerly administered by the State Board of Health. Beside
the challenge of organizing the new department, the primary mission was the
implementation of the federal Community Mental Health Centers Act that allocated
matching funds for the construction of community mental health centers.
418
The Division prepared a State Plan for Construction of these centers; and,
by July 1, 1966, eight new construction projects had been accepted. This positioned
Florida among the first states in the country to institute this type of program and
proved a major step toward providing Florida residents a comprehensive
community-based mental health care program, one that included the dispensing of
psychiatric drugs.
The program began on January 1, 1966, and allowed outpatient clinics and
Public Health Officers all over the state to dispense psychiatric drugs to indigent
patients released from the state hospitals. As the drug distribution program needed to
be overseen by a registered pharmacist, the pharmacy of the Florida State Hospital
at Chattahoochee was selected to distribute the drugs. While the State Board of
Health restricted the drugs to only those patients released from the state mental
hospitals, a plan was immediately put into place to expand the program to include all
indigent patients receiving treatment for mental disorders. The plan was also
extended for the next two years.
419
ECT Gives Way to Drug Therapy
While changes were made outside the hospital, procedures inside the
hospital were evolving as well. ECT, still used in select cases of agitated depression,
acutely disturbed patients, and patients with suicidal tendencies, gave way to drug
therapy that soon became the primary treatment with remarkable results. Coupled
with new techniques and programs, the use of these drugs was highly effective in
reducing the length of hospitalization.
420
Out of Mind, Out of Sight
153
As noted earlier, the use of drugs also proved exceptionally valuable in
rendering the patient receptive towards psychotherapy and other related therapies.
One of those therapies was Industrial Therapy, the placing of patients in various jobs
throughout the hospital.
Industrial Therapy Initiated
A total of 649 patients were placed in various occupational areas throughout
the hospital at Chattahoochee under the Industrial Therapy program. Some were
trained as dental and laboratory assistants while others worked on the grounds and at
the homes of staff living on the hospital campus. Attending psychiatrists referred
patients to the program, and those who worked were paid a stipend by the hospital
with some money set aside for patient use after discharge.
421
Of those participating
in the program, 438 were released into the community.
422
Assigned to the home of Clinical Psychologist Sam Cunningham was a
black patient from St. Louis, Missouri, named Eulish Pratt. A chronic alcoholic, he
became delusional when he drank, but, once diagnosed, he received appropriate
treatment and remained at the hospital until he was able to control his drinking.
423
A handyman with no education, Pratt reported to the Cunningham home
three mornings a week to perform odd jobs. Cunningham recounted that one time
his wife gave him a wheelbarrow that had all the pieces but wasn’t put together. One
morning Pratt came in and assembled it without an ounce of trouble. He also played
with the Cunningham children and told them stories.
When Pratt was discharged, the hospital sent him on his way with a small
amount of money and a bus ticket. Wishing him well, the Cunningham family
accompanied him to the bus terminal. The last thing they remember is Pratt’s head
stuck out the window and waving a fond goodbye. Cunningham recalled it was
very touching.
424
Unfortunately this particular program, which proved so valuable to the
patients, was terminated after only a few years because some saw it as
discriminatory since most of those in the program were African Americans.
425
New Buildings and Programs
The hospital at Chattahoochee continued to undergo physical improvement
as many of the old and outdated buildings that previously housed patients
426
gave
Sally J. Ling
154
Construction Department, 1950s. Photo courtesy of the Florida State Hospital.
way to new ward buildings to accommodate over 900 men. Future plans called for a
new kitchen and dining room, renovation of the General Kitchen, construction of an
Administration Ancillary Services Building, and additional staff housing.
The Department of Nursing Education now included a course in Psychiatric
Nursing for student nurses enrolled in six basic schools of nursing. In addition, the
hospital provided clinical facilities for learning experiences in psychiatric nursing
for a four-year collegiate nursing program, and for two two-year associate nursing
programs.
427
After the sudden death of two supervisors and the loss of another by
resignation, the Horticultural Department merged with the Sanitation Department.
The results of this six-month trial proved most satisfactory. Propagation of plants
especially azaleas, camellias, viburnum, boxwood, philodendron, lilies, and other
decorative plants
428
was initiated. As a result, the hospital grounds blossomed into
an oasis of beauty among the scrub pines and Spanish moss covered oaks, especially
in the spring.
Out of Mind, Out of Sight
155
Two major changes occurred simultaneously during the 1960s. The first was
total integration of the state hospitals, both in patients and personnel.
429
The second
was the establishment of a Personnel Department to oversee the 2,269 authorized
positions. With an average turnover rate of 17 percent, personnel staff had their
hands full terminating the services of 693 employees and filling 947 positions.
430
One of those positions was for a new Superintendent. As Rogers moved on to his
new position as director of Florida’s Division of Mental Health, Dr. J.B. O’Connor
became the Superintendent. He would go on to play an important role in Kenneth
Donaldson’s struggle for justice.
Kenneth Donaldson Continues His Fight
During his confinement at Chattahoochee, Kenneth Donaldson observed and
experienced the worst the hospital had to offer. After years of mistreatmentbread
with “spots of mold, as big as a silver dollar,” patients beaten, others given incorrect
and debilitating medicine, and patient deaths from abusea fellow inmate of
Donaldson’s suggested a patient riot. Quelling the undercurrent of discontent,
Donald convinced the patients that exposing hospital conditions in public court
would accomplish far more than risking the lives of attendants and patients if a riot
were to take place.
Throughout his ordeal, Donaldson continued his campaign to obtain a writ
of habeas corpus
431
by documenting, in code, his experiences and writing letters to
Superintendent O’Connor, Director Rogers, the chief justice of Florida, and
Governor Farris Bryant. When his petitions failed, he wrote, “As nothing ever
developed to help me after the pleas by Congressman Rodino and Governor Bryant,
and as my follow-up letters went unanswered, is it any wonder that I thought there
must be something sinister about the ‘sound barrier’ I could never quite
penetrate?”
432
Superintendent O'Connor, who served during most of this period, refused to
release Donaldson, even though the hospital staff had the power to do so. O'Connor
stated that, “Donaldson would have been unable to make a ‘successful adjustment
outside the institution,’” although at the eventual trial O'Connor could not recall the
basis for that conclusion.
433
Because of his persistence in obtaining justice and the “heat” he was taking
for it from administrators to attendants, Donaldson was transferred from ward to
ward. On each, a different doctor evaluated his condition and treated him
Sally J. Ling
156
accordingly, even if the treatment plan differed greatly from that of the doctor on the
previous ward. In one such incident, Donaldson described his experience with
Thorazine:
A 50-mg tablet of Thorazine three times a day was the dosage. I
held the first tablet under my tongue until I could spit it into the
toilet. At the second meal, attendants threatened me with the needle
if I spit out another. The Thorazine caused a narrow purple ring
beneath each eye by the second day. The third day it covered both
eye sockets and a spot on the left nostril. I sent word to the doctor
but was not called.
My hopes were at an all-time low. This was how Carter and Vittorio
had been taken care of [other patients at the hospital].
Then, again, a miracle. On the fifth morning, I went to sickbay and
the pill man took me in to Hanenson. The doctor discontinued the
medication. That was Thursday, and the spots were gone by
Saturday.
434
As Donaldson’s struggle moved through the 1960s, the national political
and medical landscape regarding psychiatric hospitals began to change.
New Perspective on Institutionalized Mental Health Care
In The Mad Among Us, Grob noted that the mental health system had
undergone a series of dramatic postwar changes. Emerging from this change was the
belief that community care and treatment of the mentally ill was far superior to
confinement in remote custodial mental hospitals; however, this new philosophy
failed to become the panacea it was intended to be. Stated Grob: The unmet needs
of severely and persistently mentally ill would force a fundamental reevaluation of
mental health policy after 1970 when new demographic factors and a different social
and political environment combined to transform both the nature of the problem and
the context in which policy was formulated.”
435
Little did Donaldson or the Florida State Hospital know that they would
soon take center stage in changes that would come to pass in this arena, both in
Florida and the U.S. during the 1970s.
Out of Mind, Out of Sight
157
Chapter Photo: Front of the Forensic Admissions building. Photo courtesy of Joe Blanton, Florida
State Hospital.
Chapter XIII
Landmark Changes Come to Florida
The national trend, prior to 1970, was to confine the mentally ill to state institutions
where their care and treatment was centralized and their numbers invisible to the
community at large. But, in the decades that followed, that trend gave way to
deinstitutionalized mental health care services. This allowed hospitals to discharge
large numbers of patients into community-based programsa system in its infancy.
Young adults who had spent extended periods in mental hospitals suddenly
found themselves discharged without the functional and adaptive skills to cope on
the outside. Alcoholism and drug abuse became rampant within their populous and
their explosive and defiant behavior
436
only intensified the problem as these young
adults became the decade’s homeless. For all the help available in community-based
clinics to these young adults and those newly diagnosed as mentally ill, there were
countless other patients in the state institutions and at Chattahoochee who still
fought for release.
Sally J. Ling
158
Donaldson’s Struggle Nears the End
Donaldson struggled for decades with every fiber of his being to get his day
in court. Now, with the engagement of a competent attorney, his case moved, though
decidedly slowly, through the Florida courts. A legal brief, dated March 24, 1971,
presented to the United States District Court, Northern District of Florida,
Tallahassee Division, was a three-part petition filed by Dr. Birumbaum on behalf of
Donaldson. It sought Donaldson’s release through habeas corpus, asked for
$100,000 in damages, and was filed as a class action “in favor of all other
involuntary patients in Chattahoochee, asking for a declaration that Florida
commitment statutes were unconstitutional, and asking for an injunction barring the
hospital staff from holding patients without adequate treatment.”
437
Before the case was heard, Dr. Walls, who became acting superintendent
when Dr. O’Connor retired, called Donaldson into his office for a chat. He described
to Donaldson his frustration with the role that Chattahoochee and other state mental
hospitals played in the care of the mentally ill:
These hospitals should not be trying to be everything. I have
watched it over the last ten years. First, it was OT [occupational
therapy], then industrial training and education. If a man can’t read
and write, it should be the job of his home county and not that of
Gadsden. Similarly, if he wants to be an auto mechanic, some other
unit of state government should teach him. It should not be the job
for a hospital. We need to get down to fundamental questions. What
is the purpose of this hospital? It should not be a dumping ground
for every county in the state for their geriatrics and morons. They
don’t belong in a psychiatric facility. And we shouldn’t have to
have guards to keep criminals from escaping. This can’t be a cure-
all. It’s gotten to be a third-grade college. It should be limited to
psychiatric cases if it is to be a hospital. Say, keep 25 percent of the
ones here. Then we could have something we could manage and do
something for.
438
For all of Wall’s frustrations, and those of the patients who were still in the
hospital, there was no relief; however, in 1971, Donaldson was finally discharged. It
was believed, however, that this was permitted as a hedge against the pending legal
action.
439
Out of Mind, Out of Sight
159
His case eventually arrived on the steps of the Tallahassee courthousea
suit filed against Florida State Hospital Drs. O’Connor and Gurmanis. As Dr.
O'Connor presented his defense, he asserted that he acted in good faith in confining
Donaldson “since a Florida state law, which had since been repealed, had authorized
indefinite custodial [to protect and maintain confinement] of the 'sick' even if they
were not treated and their release would not be harmful . . .’"
440
This defense, however, did not hold up. The jury found for Donaldson and
awarded him $5,000 each in punitive damages against Drs. Gumanis and O’Connor,
and compensatory damages of $17,000 against O’Connor and $11,500 against
Gurmanis. Donaldson was a free man, but the battle wasn’t over. He was plagued
for years by the trauma of his stay at Chattahoochee.
Eventually moving to Pennsylvania, Donaldson got a job as a hotel clerk
and lived on his own. Of that time he wrote:
Psychic shock erased simultaneously as physical health improved,
so that I could not see any separation of the two. My brain was
stunned, simply bruised so much that it halted normal activities
where possible until the fouled-up blood from fifteen years of
beatings drained away. I could read newspapers twice as fast the
second year, four times as fast this year . . . I have told of the death
of emotions, which I noticed during my last years in Chattahoochee.
A full complement of feelings has returned gradually over the years
of freedom. During the long fight for vindication, anger has waned
and friendships have grown.
441
Donaldson’s case was appealed to the Court of Appeals for the Fifth Circuit.
While the original ruling was affirmed, Dr. O'Connor appealed the decision all the
way to the U.S. Supreme Court. On June 26, 1975 in a nine to zero decision, the
Supreme Court of the United States upheld the decision of the lower courts and
established three important rulings:
First, it established that mental illness alone does not justify confining a
person against their will for an indefinite period of time.
442
Second, the court
affirmed that state hospital officials could be held liable for damages if “their actions
were carried out ‘maliciously . . . or oppressively’ and with the knowledge that their
actions violated a person’s constitutional rights.” And third, the court acknowledged
that the rights of the mentally ill should be protected, but it did not clarify whether
the mentally ill have a constitutional right to treatment if they are hospitalized.
443
Sally J. Ling
160
Chatt-a-gram, the Florida State Hospital newspaper that started in 1975 as
an informational service for patients and staff of the Chattahoochee hospital,
commented on the Supreme Court decision in the Donaldson case. An article stated
that the case was of “great concern” to all and that the hospital was currently
developing guidelines to aid the units in implementing proper treatment programs.
444
Sam Cunningham, Florida State Hospital Clinical Psychologist (1950-1988)
who performed diagnostic testing on Donaldson to see if he recovered from his
schizophrenia, stated that Donaldson was never quite together mentally and that his
family was afraid of him because he had made threats against them. Said
Cunningham, “I can’t say he recovered from his mental illness. He varied from
Out of Mind, Out of Sight
161
Dust Jacket from Insanity Inside Out. Photo
courtesy of author.
being quite pleasant to being obstructive. He was never bad and never did anything
to harm anyone. The main thing was that he wasn’t a danger to himself or others.
You have to learn to tolerate these people.
445
Donaldson’s experience at
Chattahoochee and his subsequent
fight for justice were described in his
book Insanity Inside Out, published in
1976. During the late 1970s, he toured
the U.S. promoting his book and
championing the rights of mental
patients. He died in Arizona in
1995.
446
“Chattahoochee,” a movie
based upon fellow inmate Emmett
Foley’s similar experience at the
Florida State Hospital, was released in
theaters in 1991. This saga portrayed
the story of Foley, a Korean War
veteran, who was depressed and
shattered by continual unemployment.
Shooting up his neighborhood, he
hoped police would gun him down so
his wife Mae could collect the
insurance money. Instead, he was sent
to Chattahoochee where the shocking conditions at the hospital resulted in him
becoming dispirited.
Encouraged by a friend, he drew upon his anger to write letters to
authorities protesting the sub-human conditions in the mental facility. His efforts
resulted in a state commission formed to investigate conditions at Chattahoochee,
and an opportunity for him to tell the world through his movie of the horrible
conditions.
The Baker Act
While Donaldson’s case moved through the courts (some suggest perhaps
even because of it), on July 1, 1972, history-making legislation came before the
Sally J. Ling
162
Florida Legislature that would bring about a comprehensive revision of Florida’s 97-
year-old mental health care law. It would also strengthen the due process and civil
rights of persons in mental health facilities.
447
From the inception of Florida laws back in the late 1800s that governed the
treatment of the mentally ill, residents could be committed if affidavits were signed
by three persons and secured the approval of a county judge. The law further stated
that any destitute person considered “mentally ill” was to be placed in the Sheriff’s
care until he or she could be transported to the state hospital. Restrictions allowed
only one individual with whom the patient could correspond, and the individual
could be confined for an indefinite period of time before a judge would review the
case.
448
The 1972 bill before the Florida Legislature would make a dramatic change
in that law.
The Act, commonly referred to as the “Baker Act,” was named after Maxine
Baker, former State Representative from Miami who sponsored the legislation after
serving as chairperson of the House Committee on Mental Health. According to
Cunningham, Baker was a tiny lady who insisted the Legislature became more
interested in mental health issues.
449
An advocate for the mentally ill, she wanted Chattahoochee to have an
atmosphere that was decidedly home-like. Cunningham described Baker’s reaction
to a patient’s artistic expression when she visited the hospital:
After the forensic unit was built, we had a patient on one of the
wards who was quite an artist. There were blank walls to the right
and left as you entered the ward, and he said he would like to do a
mural. He painted a woman on a sofavery nudewith her arm
up, but he did it very well. Of course it was larger than life. Then he
said, “Men should have equal treatment,” so he painted a man on
the other side.
One day Ms. Baker decided she wanted to tour the hospital
unannounced. She came in and stopped inside the door and took in
the picture of the woman for a lengthy time. Then she turned and
looked at the man. “Now this is what I mean by home-like
atmosphere,” she announced. I thought, “Sister you are really with
it.”
450
Out of Mind, Out of Sight
163
State Representative Maxine Baker. Photo courtesy of the
Florida State Archives.
Baker Act Brought Changes
The Baker Act barred the indiscriminate admission or retention of persons
without just cause to state institutions. It also mandated court-appointed attorneys to
represent each person for whom involuntary placement was sought, and provided for
independent reviews every six months of all involuntary placements The new law
established a patients’ bill of rights, protecting persons’ rights to communicate with
whomever they wished, to receive and send unopened mail, to use their own
possessions, and to vote, as well as many other rights. The law also prohibited the
placement of persons with mental illnesses in jails unless they had committed
criminal acts.
451
When enacted, the Baker Act had a profound effect and was considered by
many throughout the country as landmark legislation. While it has undergone a
number of revisions, these reflect the evolution of the mental health care system and
the way it evaluates and treats the mentally ill, while continuing to protect their
rights.
Sally J. Ling
164
Reflections of a Former Administrator
Bob Williams, former administrator, remarked that three things happened
within a short time of each other that changed Chattahoochee forever: Thorazine
was used on schizophrenics, the Community Mental Health Act created the capacity
in communities and throughout the nation for the establishment of community-based
clinics, and the Baker Act, for the first time, established some fairly rigorous criteria
regarding whom should be served in a state hospital and how long they should stay.
But nothing happened instantaneously, leaving the Baker Act’s substantive
improvements to evolve over time.
452
When Williams came to the hospital in 1978, he was asked to reorganize the
institution and to move it from a departmentally structured heavily medical
organization into broader psychiatric rehabilitation [holistic care]. Upon his arrival,
he found many more challengessome as old as the hospital itself.
The first major event I found out was there were horrendous abuses
in geriatric wards, including the heating of keys and pressing them
it into the flesh of the elderly. Others included driving patients
down the hallways with their pants around their ankles for baths and
mealtimes. I took a strong position and terminated several staff.
There were challenges to those terminations, but they were upheld.
Those abuses stopped, but there were others in the geriatric units.
Anytime you have a large facility there is a certain small element
that will try to abuse people. I don’t know if we ever completely
eliminated it.
453
During Williams’ tenure, the hospital was reorganized, a move that allowed
the professionals to work as a team to evaluate the patient both physically and
mentally, and prescribe treatment that looked at the patient holistically.
454
New Forensics Hospital Opens
In 1973, the original Thronateeska golf course gave way to the new forensic
hospital, built to accommodate those criminals who were ruled Not Guilty by
Reason of Insanity. Sam Cunningham was the clinical psychologist at
Chattahoochee who received some of the first patients. At 5’ 11” and weighing just
119 lbs., he was just recovering from a heart attack when some of the most difficult
Out of Mind, Out of Sight
165
patients from the South Florida State Hospital in Hollywood arrived at
Chattahoochee:
They couldn’t handle the patients and sent them all in leg and hand
restraints. They marched them into a 36-person ward with
psychiatric aids, so I got them together and removed their restraints.
They sat there looking shocked. I picked out the biggest, meanest
one, and to keep order during the meeting once a week, designated
him as Sergeant at Arms. I told them, “You elect a chairman, and
somebody you trust. Every day I’ll contact him to see what the
complaints are.” They turned out to be regular pussycats. It was
really funny. I told them, “I’ll be reasonable with you if you are
reasonable with me or we won’t keep you on the ward.” The big
tough man grew flowers by his bed, and they were all very
attentive. They were more court cases than mental cases and had
acted like they were more in jail then a hospital. When they were
treated like human beings, they acted like them.
455
State Wide Deinstitutionalization a Challenge
In a draft of a concept paper submitted by the Mental Health Program Office
on February 17, 1978, an overview was presented of the many challenges facing the
state in implementing a deinstitutionalization program. These included: the image
of “State hospital patients locked in slovenly, prison-like settings, suffering from
neglect, over-medication, and abuse by staff and other patients; the image of ex-
patients living in inner city slums, untreated, isolated, starving and exploited by
those around them; and the image of ex-patients disrupting an otherwise tranquil
environment with crime and violence, all come to the fore with the mere utterance of
the word ‘deinstitutionalization.’”
456
Yet, despite these concerns, deinstitutionalization became a reality, and
community-based treatment centers were established throughout the state. This led
to the gradual phase down of state hospitals leaving them to treat forensic patients
and the chronically mentally ill.
Reorganization Creates Department of Children and Family Services
The Department of Health and Rehabilitative Services (HRS) began
reorganization in 1991. This created new agencies to serve clients previously served
Sally J. Ling
166
by HRS. The Legislature created the Department of Elder Affairs in 1991, the
Agency for Healthcare Administration in 1992, the Department of Juvenile Justice
in 1994, and the Department of Health in 1996. In 1996, HRS officially closed, and
the Department of Children and Family Services (DCF) was created. Since then, the
Florida State Hospital has operated under its jurisdiction.
457
Florida Today
Today, seven mental health treatment centers serve Florida’s population.
Three are operated by the state: Florida State Hospital (Chattahoochee), Northeast
Florida State Hospital (Macclenny), and North Florida Evaluation and Treatment
Center (Gainesville). Four others are managed privately: South Florida State
Hospital (Pembroke Pines), South Florida Evaluation and Treatment Center (Florida
City), Treasure Coast Forensic Treatment Center (Indian Town), and West Florida
Community Care Center (Milton).
The Florida State Hospital at Chattahoochee currently serves 2,000 people a
year and consists of two institutions in onethe Forensic facility and the Civil
facility. Capacity for both facilities is 1,042.
The Forensic facility contains 528 beds and serves those committed by the
court as Not Guilty by Reason of Insanity or Incompetent to Proceed. Located in
two different sites on hospital grounds, Forensic Services residents are housed in the
Admission and Evaluation Service (Units 23 and 24), and the Central Forensic
Service (Units 21 and 25).
Admission and Evaluation Service (Units 23 and 24): Units 23 and 24
are admission and treatment sites. Each unit in this maximum security
facility contains 100 beds for male forensic commitments. Primary
activities are assessment of new admissions, short-term treatment, and
competency restoration for defendants Incompetent to Proceed, and
behavior stabilization for persons committed as Not Guilty by Reason of
Insanity. Unit 23 also administers a medical complex with an infirmary
and dental clinic.
Central Forensic Service (Unit 21): Unit 21 in Central Forensic provides
longer-term treatment for male residents. This 160-bed unit primarily
serves a seriously and persistently mentally ill population of male
Out of Mind, Out of Sight
167
defendants who are Incompetent to Proceed or Not Guilty by Reason of
Insanity.
Central Forensic Service (Unit 25): Unit 25 in Central Forensic includes
four living areas for women and two for men. This 168-bed unit admits
and treats women who have been committed as Incompetent to Proceed
or Not Guilty by Reason of Insanity. The unit also provides longer-term
treatment for male residents.
Forensic Admissions and Rehabilitation Services: Coordinates all
Forensic admissions in conjunction with the Mental Health Program
Office, coordinates intra unit transfers, works with the Office of Social
Services in the coordination of interstate transfers, maintains resident
records, and provides therapeutic activities which include Arts and
Crafts, Music, Computer Classes, Substance Abuse, Self-Image, and
Competency Education within the secure perimeters of Forensic
Services.
458
In addition to the Forensic facility, the Civil facility serves those individuals
who have been released from the Forensic unit and those who have been Baker
Acted (under evaluation according to the Baker Act). It also serves those who are
intellectually challenged and have a mental illness. Scattered throughout the state,
other Florida Department of Children & Families Mental Health Treatment
Facilities serve the mentally ill in a variety of capacities.
In 2009, the Florida State Hospital at Chattahoochee received its first three-
year accreditation certification from the Commission on Accreditation for
Rehabilitation Facilities (CARF). It received its second certification in 2012.
459
Three years is the maximum achievable length of time for accreditation.
460
Role of the Mental Health Professional at Chattahoochee
According to Larry Annis, who retired at the end of 2010 after 28 years of
service at the hospital and who served as Chief psychologist for the last 20 years of
his service, when a prisoner was admitted to the Florida State Hospital, he or she
was moved from “inmate” to “resident” status and treated as a patient. He cautioned,
however, that the patients came to the facility with high risk: “Most of the people we
see are dangerous. They are killers, or would be killers if they had shot a little more
to the left or they got their knife out in time.”
461
Sally J. Ling
168
Ellen E. Resch, PhD., Dialectical Behavior Therapy & Substance Recovery
Director and Psychology Training Director, who has served the hospital for over 30
years, stated that once the prisoner became a resident, the interdisciplinary mental
health team took over. This process involved review of the “admission paperwork to
determine the exact legal stage of proceedings, the Court's order as to nature of
evaluation and due date, the mental health issues identified as problematic, the
health records at the previous place of residence, the mental health and social history
of the person, etc.”
462
Annis noted that if the resident had mental health issues, those
typically surfaced before the crime, and there was usually something in the record.
Personal interviews, observations, psychological testing, and medical testing
are then performed to assess the individual, whom Annis described as typically
uncooperative. During the personal interview, the evaluator usually asks questions
that range from global to specific, establishes who the evaluator is, and what the
restrictions are on privacy. Then, the evaluator attempts to engage the person in
conversation and develop rapport. The clinician also looks at the resident’s response
style, and in the evaluation, asks about specific issues and why the resident is
there.
463
Once the evaluation is concluded, a treatment plan is devised. This plan
takes into account the legal basis for commitment, the assessed nature of the
problems or the diagnosis, the person's risk factors and all their safety/security
needs, and the person's motivation or interest in taking part in the services. At the
conclusion of the assessment, team members discuss their observations and findings,
and each is then assigned specific responsibilities for assessment or treatment that is
consistent with their expertise. Throughout the resident’s stay, his or her progress is
documented, discussed, and used to adjust the service plan as needed.
According to Resch, specific focus on the person's clinical/legal competency
issue is the responsibility of the psychology staff that is trained to understand the
forensic mental health evaluation process. Eventually, the psychologist and team
reach a decision that, from a clinical perspective, achieves the purpose of the Court's
commitment.
At the conclusion of the evaluation and treatment process, the team's
findings are sent in a report to the committing Judge. Copies of the report are also
distributed to the defense counsel, prosecution, Clerk of Court, and other parties as
necessary. The resident is then discharged from the hospital, and the Court orders
him or her transported to the next setting where the legal sequence of events
resumes.
464
Out of Mind, Out of Sight
169
Hospital Receives Awards
In 1999, the Florida State Hospital at Chattahoochee received the
prestigious Governor's Sterling Award for Organizational Excellence, based
upon the Baldrige criteria. A national public-private partnership, the Baldrige
Program helps U.S. organizations improve their performance by:
Helping organizations achieve best-in-class levels of performance
Identifying and recognizing role-model organizations
Identifying and sharing best management practices, principles, and
strategies
465
Despite the award, the hospital still had its challenges.
Sally J. Ling
170
Out of Mind, Out of Sight
171
Chapter Photo: Maximum security (1930 or earlier). Photo courtesy of the Florida State Hospital.
Chapter XIV
Risk and Reward
Patient Rights VS Staff Rights
In September 2006, the death of a staff member at the Florida State Hospital at
Chattahoochee drew attention to the risk faced by employees at the forensic unit
when James Smith, 52, suffered a heart attack after a patient attacked a co-worker. A
treatment and rehabilitation specialist, Smith collapsed while monitoring the violent
patient after his injured co-worker was taken for treatment.
In an incident a year later, Kelvin Haywood’s left bicep showed an arc of
teeth marks and a scar on the right side of his neckeach an indication of the
dangers of the job. Even Joe D’Agostino, a psychologist, fell victim to the violence
on the forensic wards when a gash on his head from a patient wielding brass
knuckles required seven staples to close. In fact, many of the workers bore scars and
Sally J. Ling
172
told of frequent threats, fights, gangs, and homemade knives or cudgels, known as
“locks in socks.” These incidents were among many that occurred in the unit since
its inception. Although the unit was not understaffed at the time of the incidents, a
Department of Children and Families inspector general’s report noted that at times
units were often unmanned for minutes or even hours at a stretch. The report also
highlighted several security issues.
Between April 2004 and April 2006, Unit 23 had a 145 percent increase in
aggressive behaviors, with Unit 24 at an 87-percent increase. Overall, the increase in
aggressive behaviors for both units stood at 116 percent; yet, the report pointed out
that during that same time period there had been little or no increase in staff.
466
This
left the staff at risk. At issue were the rights of patients versus those of the staff, as
well as equal pay, and acquisition of the same protections and reinforcements given
prison guards.
Forensic patients charged with murder, assault, rape, and other major
offences for which a competent defendant would be charged with a felony, arrived
at the Florida State Hospital in chains; but, once they entered the facility, they were
referred to as “residents” who were there for treatment. Disruptive residents were
given an appropriate 15-minute time out, with handcuffs or strapping down being
acceptable for short durations. If the resident required further discipline, he or she
was sent into seclusionquarters with concrete floors, metal doors with an opening
for passing meals, and a plastic chair. A mattress was brought in at night for
sleeping.
Jim Baiardi, who at the time was president of the Police Benevolent
Association correctional-officer chapter that represented the security staff,
corroborated remarks made by attendants and security officers who told legislators
they thought some patients were faking mental illness or deficiency to spend their
time in an atmosphere preferable to the prison system.
There existed a delicate balance between the rights of the patient and those
of the staff. Attorney Kathryn Dutton-Mitchell, manager of the institutional
conditions team at the Advocacy Center, represented seven mentally challenged
residents who were held in seclusion for more than a week because of an earlier
mêlée. The incident started when a lieutenant and security officer accompanying a
nurse delivering medicines entered a ward of intellectually disabled residents. One
patient refused to take his medicine, and another was stopped when he wanted to
leave to use the phone. The patients were forced back into the ward and began
kicking the door held shut by the security officers. When a supervisor entered the
Out of Mind, Out of Sight
173
ward, a resident attacked him, hitting him in the right cheek with his fist and
knocking out three of the lieutenant’s teeth.
Both the Chattahoochee Police Department and the Gadsden County
Sheriff’s Department were called. Upon arrival, they found the wards increasingly
unmanageable. A resident who appeared to be the leader was subsequently sprayed
with mace after which the disturbance was quelled by the police officers.
Representative Marti Coley of Marianna County conceded that patients had
rights but noted that employees have a right to a safe work environment.
Representative Curtis Richardson of Tallahassee agreed: “If we focus too much on
the rights of patients, we’re not going to have any staff to serve them.”
467
In order to insure the safety of employees, residents, and visitors, Diane
James, former hospital administrator, stated that the Hospital remains proactive by
providing the best training and tools available to be able to identify and manage the
rare occasions when urgent circumstances occur.” This includes training and
education in conflict resolution, crisis response, gang recognition, and safety
awareness. In addition, annual training classes are required in myriad subjects under
such headings as: employee and resident safety, hospital policies, policies specific to
Forensic Services, and environmental and work practice controls.
468
Hospital Break Out
Injuries to staff were only one concern of hospital administrators. Attempted
escapes, though quite rare, were another, especially when they involved help from
the inside. In February 2008, Donald Ray Moore, 22, an employee of the hospital,
was fired in the middle of his probationary period after authorities found a hacksaw
blade in the trash. The blade, it was later learned, was supplied by Moore to two
forensic residents who attempted an escape.
In the escape attempt from a secure unit, the residents, who were found unfit
to stand trial for their crimes, were found on the roof of Pod F after having escaped
through the window of their room. Placing dummies in their beds to make it look
like they were sleeping, the two removed glass from the bedroom window that they
subsequently hid under a bed. After crawling out the window, they made it to the
roof where they remained about 15 minutes before being discovered by hospital
staff who called police after noticing their absence from the secure unit. The men
were found wearing two layers of clothes.
469
Sally J. Ling
174
Hallway of the Behavioral Isolation Unit (BIU). The BIU area closed many years ago. The
philosophy of utilizing "isolation" as a treatment modality changed, and efforts have since been
focused on the reduction of the use of seclusion and restraint (S/R). With this change in focus, any
need for the use of S/R (which is low) is now handled on the resident's home unit. Photo courtesy
of Joe Blanton, Florida State Hospital.
Since neither resident had exhibited any previous behavior problems, the
escape attempt was most unexpected. According to James, after the escape attempt,
each resident was clothed in a jumpsuit and placed in seclusion on 1:1 special (1:1
special means one staff person to one resident at arm’s length at all
times). Visitation was suspended, and hospital security escorted the residents when
they moved from seclusion. Charges were also filed against both residents.
470
Competency and Death Row Inmates
Over the decades, the Florida State Hospital has been home to thousands of
criminals deemed incompetent to stand trial, but the most notorious of them all have
been death-row inmates. Sent to Chattahoochee to receive evaluation and treatment,
the hope was they would emerge competent enough to return to the county courts to
continue the trial process or be returned to the Florida State Prison at Raiford to
serve out their sentence until their scheduled execution either by Florida’s electric
chair, known as Old Sparky, or lethal injection. A U.S. Supreme Court ruling in
1986, based upon a case involving an inmate at the Florida State Prison, however,
changed all that. The ruling allowed dozens of prisoners to remain on death row for
Out of Mind, Out of Sight
175
decades, some even indefinitely, even though they were convicted and sentenced to
die.
Here are the stories of three Florida death row inmates who experienced
mental illness and were intimately connected to the Florida State Hospital. Like
Kenneth Donaldson in the 1970s, Alvin Bernard Ford’s case went all the way to the
U.S. Supreme Court and won a significant rulingone that affected states
nationwide. The other two inmates spent time at the Florida State Hospital during
some part of their incarceration on death row.
Alvin Bernard Ford
The case that changed the face of death row across the country started in
Florida with Alvin Bernard Ford. He was only 20 when, on July 21, 1974, he and
three others planned and executed an armed robbery at a Red Lobster restaurant in
Fort Lauderdale. While the crime was in process, two people from the restaurant
were fortunate enough to make their getaway. This prompted the robbers to believe
they would contact police who would soon be dispatched to the restaurant. In light
of this, all the robbers, except for Ford, fled the scene. Not realizing his accomplices
had left, Ford remained behind and snatched approximately $7,000 from the
restaurant's vault.
Officer Dimitri Walter Ilyankoff responded to the police dispatch and
arrived on the scene by himself, only to run into Ford in the parking lot. Ford shot
the officer twice in the abdomen. Looking for his accomplices and realizing they
had abandoned him, Ford ran to the parked police car intending to make a fast
getaway. When he found no keys in the ignition, he returned to the wounded and
struggling police officer and demanded the keys. Without results, Ford then shot
Ilyankoff in the back of the head at close range, grabbed the keys, and escaped in the
officer’s cruiser.
Police apprehended Ford at his mother’s home in Gainesville. Said to be
suffering from depression and drug addiction at the time of the robbery, he was
charged with murder and held for trial. Convicted of first-degree murder in Circuit
Court, Broward County, Florida, the jury recommended the death penalty, and the
trial judge pronounced the sentence on January 6, 1975. During the first six years of
his incarceration while waiting for his appeal, Ford’s physical and mental health
appeared normal, and on November 4, 1981, Governor Bob Graham signed his
death warrant. Ford’s execution was scheduled for December 8, 1981.
Sally J. Ling
176
As his execution date neared, Ford began developing delusions and
hallucinations. Just 14 hours before he was to be executed, the Eleventh Circuit
Court of Appeals in Atlanta granted him a stay of execution. Ordered to undergo
psychiatric evaluation, Ford was examined by three psychiatrists in the courtroom at
the Florida State Prison where the doctors spent 30 minutes interviewing him.
Afterward, they, along with an attorney from the governor’s office, correctional
officers, two paralegals, and two defense attorneys spoke with correctional officers.
They also examined Ford’s cell, reviewed his medical records, and discussed his
condition with the medical staff. Under separate reports to the governor, one
psychiatrist described him as “severely disturbed” and the two others described him
as “psychotic; however, each determined that Ford understood he had been
sentenced to death for his crime.
Ford was subsequently found competent for execution, and the Governor
signed a second death warrant on April 30, 1984. An execution, date of May 31,
1984, was set. Just as before, with only 14 hours to go, he was granted a second stay
of execution. At issue now was whether the execution of an inmate who was
considered “incompetent” fell under the U.S. government’s definition of cruel and
unusual punishment. Up to this time, the Eighth Amendment argument had been
used to determine method and amount of punishment, but Ford’s case argued that
execution of the insane was cruel and unusual.
Ford’s case was brought before the United States Supreme Court, which
ruled on June 26, 1986, that “the Eighth Amendment prohibits states from inflicting
the death penalty upon prisoners who are insane and found that Florida's procedures
for determining sanity had failed to adequately protect Ford's rights.” While the case
did not decide Ford’s sanity, capital punishment experts Kent S. Miller and Michael
L. Radelet wrote about the impact this decision had on the treatment of mentally ill
prisoners on death row: "Alvin Ford made history as the man who forced the
criminal justice authorities, lawyers, judges, politicians, mental health professionals,
and a host of others to seriously debate the question of what types of mental illness
should exempt condemned prisoners from execution and how (and by whom) these
life-and-death determinations should be made."
Up until this time, no clearly defined protections shielded the mentally ill
from execution. This ruling took the final decision out of an individual governor's
hands through clemency hearings and placed it in the court system.
In 1989, Ford was evaluated again and found competent for execution.
Another appeal was about to take place when, on February 2, 1991, he was found
Out of Mind, Out of Sight
177
dead in his cell at age 37 of adult respiratory distress syndrome associated with
fulminant acute pancreatitis.
471
Aftermath of the Ruling
The Ford case was analyzed in an article published in 2008 by Amnesty
International Magazine which concluded that: “Justice Lewis Powell drew his own
line, reasoning that the Constitution protected only those who are so insane that they
are ‘unaware of the punishment they are about to suffer and why they are to suffer
it.’ Justice Powell concluded that Florida could execute Ford if he became sane
again, presenting a cruel irony: death row inmates who become insane must remain
insane to avoid execution. Moreover, the Ford decision left the determination of
sanity up to each state and herein lies the heart of the problem.”
The article also noted that of more than 1,700 death row inmates at the time
of the ruling, over a dozen had insanity assertions made on their behalf. The article
further noted that the American Civil Liberties Union estimated that up to ten
percent of the more than 3,400 inmates on the nation's death rows had serious
mental illnesses. Regardless of the numbers, the article stated that mental health
experts agreed that many mentally ill prisoners would never have made it to death
row in the first place if they had been able to find treatment when they were free.
472
The U.S. Supreme Court ruling in Ford’s case would eventually affect Gary
Alvord, another Florida death row inmate.
Gary Alvord
Gary Alvord, alias Paul Brock, who was convicted and sentenced to death
for the 1973 triple homicide of a family of women, still sits in his cell on Death Row
awaiting executionone that may never come. Deemed incompetent by reason of
insanity, Alvord gained his reprieve because of the Ford ruling that does not permit
the execution of a person deemed incompetent.
On June 18, 1973, Hillsborough County homicide detectives were called to
a residence in reference to a triple homicide. They found the body of Georgia Tully,
53, in the back bedroom of her house; Ann Herrman, 36, daughter of Georgia Tully,
in the hallway between the living room and the kitchen, and Lynne Herrman, 18,
granddaughter of Georgia Tully, in the kitchen. All three women died of
strangulation with a nylon cord, and sperm was discovered in the vaginal tract of
Sally J. Ling
178
Lynn Herman. Time of death was estimated sometime between Saturday, June 16,
1973, and 1:30 p.m. on Monday, June 18, 1973.
Police identified Paul Brock as the suspect who had skipped town with his
girlfriend and her son. A week later, the sheriff’s office received a call from Brock’s
girlfriend who told them Brock had confessed to murdering the three women and
that his real name was Gary Alvord.
Alvord’s family had a history of mental illness, and he, in fact, had mental
health problems of his own. He claimed his mother was treated and hospitalized off
and on for schizophrenia. After his birth, he said she had a complete breakdown and
was immediately hospitalized. He also claimed his father blamed him for her
breakdown and became abusive toward him. At age 11, he was placed in a number
of foster homes where foster parents continued the cycle of abuse.
Institutionalized in Northville Hospital in Michigan at age 12, Alvord
received a number of diagnoses including Sociopathic Personality Disorder, Passive
Aggressive with underlying Schizophrenia. It was also noted that his behavior could
be described as psychotic.
He escaped numerous times and, while out, participated in violent behavior
including a shooting that involved his brother-in-law. In 1963, Alvord was sent to
the maximum-security hospital for the criminally insane at the Iona State Hospital in
Michigan where he was diagnosed with Schizophrenic Reaction, Paranoid Type.
After another escape, he was arrested for the kidnapping and rape of a 10-
year-old girl. Subsequently tried for the crime in 1970, he was found not guilty by
reason of insanity. In 1971, he escaped again but was quickly apprehended. In 1973,
despite his history and classification as a “dangerous offender,” he was granted
leave from the hospital. It was during this time that he traveled to Florida. He was
on “escape status” when he committed the murders of Tully, her daughter, and
granddaughter.
Throughout the trial, Alvord’s attorneys alleged that he was not competent
to be executed; and in 1973, while his trial was in process, he was transferred to the
Florida State Hospital to determine his competency. Dr. Daniel J. Sprehe found him
competent, and Alvord was returned to the Florida State Prison at Raiford.
Governor Graham, who didn’t want to sign the death warrant before
allowing for a competency hearing, appointed three physiatrists who traveled to the
prison to evaluate Alvord who refused to cooperate. After several delays, the
Out of Mind, Out of Sight
179
Governor signed the second Death Warrant on November 2, 1984, and ordered
another competency hearing. Alvord was transferred to the Florida State Hospital
where he remained for three years before being transferred back to death row. He
was eventually found “incompetent by a panel of psychiatrists appointed by the
governor.
At the time of this publication, he remains on death row. He has been there
for almost forty years.
473
John Huggins
In August 2009, the Florida State Hospital hosted another death-row inmate.
John Huggins, 47, was twice convicted in 1998 for strangling Orlando resident Carla
Larson, 30, after she left work. Her partially buried body was found near Disney
World.
After taking her daughter to daycare on the morning on June 10, 1997, Carla
Larson went to work. Around lunchtime, she left to go to the grocery store to pick
up food for an afternoon meeting. She never returned.
Witnesses stated they saw a white Ford Explorer matching Larson’s vehicle
parked in a wooded area off the Osceola Parkway. Two days later, witnesses led co-
workers to the spot in the woods where they had seen the parked vehicle. It was
there Larson’s body was discovered; she had been strangled. Her vehicle was
missing, as well as her jewelry, clothing, and purse.
The day Larson disappeared, John Huggins, his wife Angel, and their five
children were visiting the Orlando area. That same day, Fay Blades, Huggins
mother-in-law, stated that when she came home from work, she observed a strange
SUV parked in her carport. A week later neighbors stated the vehicle was painted
black.
Sixteen days after Larson’s disappearance, police got a call to investigate a
burning black truck in a vacant lot in Cocoa Beach. It was determined to be Larson’s
SUV. The very next day, Huggins and his sister-in-law, with whom he had begun an
affair, fled Florida. Several days later, Angel Huggins was watching America’s
Most Wanted, which, coincidentally, was featuring Carla Larson’s murder.
Suspecting her husband of being the killer, she called police.
Sally J. Ling
180
Left: Outside a room in the Behavioral Isolation Unit. (BIU). Right: Inside a room in the BIU.
(This unit is no longer used.) Photo courtesy of Joe Blanton, Florida State Hospital.
Officers searched Blades’ home several times but found no tangible
evidence. Convinced Huggins was guilty, Blades subsequently conducted a search
of her own. In her shed, she uncovered jewelry identified as belonging to Larson.
Initially convicted and sentenced to die, Huggins, who had a criminal
history of robbery with a deadly weapon in 1979, to grand theft in 1995, was granted
a second trial when it was determined that prosecutors had withheld potentially
helpful evidence from the defense in the first trial. The conviction and sentence were
set aside, and a new trial was ordered. The second trial resulted in the same
conviction, and for a second time Huggins was sentenced to death.
In the post-conviction phase, Huggins was determined to be incompetent to
assist his council and was sent to the Florida State Hospital at Chattahoochee in the
hopes that his competency could be restored. He was placed in solitary confinement
in a building that serves as a medical services building for other inmates. Huggins
Out of Mind, Out of Sight
181
was separated from them by a heavy metal door containing a small, shatter-proof
window. The cell contained only a bed and toilet. A guard at the console controlled
the door electronically.
After two months, Huggins appeared before Orange-Osceola Circuit Chief
Judge Belvin Perry where a psychologist who evaluated Huggins stated that the
convicted killer was competent to proceed. Huggins, now 48, was subsequently
returned to the State Prison at Raiford;
474
however, his fate still appeared in
question.
In October of 2010, Tampa psychologist Richard Carpenter determined that
Huggins “demonstrated signs of mental illness” and was thought by his defense
team to be “delusional with a sense that there is a vast conspiracy by others against
him.” The conspiracy included federal agents and the Dixieland Mafia who he
believed were framing him.
At the time of this writing, Judge Perry was deciding how to proceed in the
Huggins case as Huggins repeatedly refused to cooperate with his defense team and
filed papers to have his legal team removed.
475
He continues to sit on death row, and
his fate is yet to be determined.
Sally J. Ling
182
Out of Mind, Out of Sight
183
AFTERWORD
The history of the Florida State Hospital’s physical plant—from federal
arsenal to Freedman’s Bureau, from state prison to state mental institutionis as
fascinating as it is remarkable; and, preservation of the historic buildings is a most
commendable endeavor. It is, however, the human drama within the facility played
out in decades that gave us the most compelling reason for this story.
Thousands of Florida’s mentally ill entered the confines of the Florida State
Hospital at Chattahoochee with the hope of being cured. From Betsey Yulee,
Chattahoochee’s first mentally ill inmate, to Kenneth Donaldson’s 15 year struggle
for freedom, to death row forensic patient Alvin Ford, each displayed the diverse
face of mental illness, a disorder that in any given year affects an estimated 26.2
percent of Americans ages 18 and older, over 57 million Americans.
476
Some may wonder why an account of the obscure facility at Chattahoochee,
its staff, and patients as set against a history of mental health care in Florida, is
important. The answer lies in its dual role as historic physical facility and evolving
mental institution that, when combined, paint a poignant portrait of Floridaits
history, its laws, and its people. It is incumbent upon historians to preserve this
picturethe good, the bad, and the uglyfor generations to come.
Sally J. Ling
184
Out of Mind, Out of Sight
185
Eleanor “Lolo” Woodham Tomlinson. Photo courtesy of Rebekah Tomlinson Mendoza..
POSTSCRIPT
Living with Lolo
Thus far, the reader has had an inside look at the evolution of the Florida State
Hospital at Chattahoochee as set against the evolution of institutionalized mental
health care throughout the nation and Florida; and, the reader has heard the voices of
those who lived the experience, whether they were doctors, patients, or staff. It
would be a grave disservice if this story did not include another perspectivethat of
a family who lived with a mentally ill patient that was sent to Chattahoochee.
For that, we turn to Rebekah Tomlinson Mendoza, whose mother Mrs.
Eleanor “Lolo” Woodham Tomlinson, was initially committed to the Florida State
Hospital in 1956, and who, for the next 18 years, was admitted and discharged
multiple times, finally being released into foster care in 1974. She died in December
2008 at the age of 93, never having been fully free from her disease.
Sally J. Ling
186
Rebekah, who is retired from both Chrysler Financial Corporation and Rose
Printing Company, now lives in Tallahassee, Florida. Before returning to
Tallahassee in 1969, she was a photographer in the U.S. Navy. This is the story of
her family, the profound affect her mother’s mental illness had upon them, and her
recollection of her mother’s time at Chattahoochee.
The Early Years
The Woodham family was Scotch-Irish, and by trade, a very industrious and
successful lotmostly farmers and merchants. They arrived in this country in the
late 1600s and early 1700s and initially settled in the Virginia and Maryland area.
Hearing the silent call to move south, they briefly moved to Old Dobbs County,
North Carolina, before relocating to Darlington County, South Carolina, where they
laid down family roots.
After nine years of marriage, Sullivan and Lalla Woodham welcomed their
first child, a daughter whom they named Eleanor. During the first six years of her
young life, she cherished being the only child and became very close with her
parents, especially her father. A second child, Sara Martyn, arrived six years later
and became Eleanor’s playmate and lifelong friend. It was little Sara Martyn who
called her big sister “Lolo,” pronounced La-La, when she couldn’t quite grasp her
longer name.
At first, Sullivan ran a grocery in town, but when Martyn was only a few
months old, he gave up the grocery business to move the family of four out to the
country where he managed a small farm of about 75 acres.
Growing up on a farm in rural South Carolina required the entire family,
including the girls, to share in the household and farm chores. The girls fed the pigs
and chickens, picked vegetables and fruit, and shelled peas and beans. Under the
tutelage of their mother, they learned how to make cornbread and biscuits; but, their
domestic chores never interfered in their learning the “proper” things of life—
etiquette and manners. After all, they were Southern Belleswell-bred and well
educated.
Lolo was a natural at the family’s piano. Taking lessons, she became quite
accomplished, surpassing even her teacher’s expectations. Winning numerous
awards for her musical prowess, she went on to study at Coker College, a liberal arts
college in Hartsville, South Carolina. During her junior year she suffered a “nervous
Out of Mind, Out of Sight
187
Eleanor “Lolo” Woodham Tomlinson
and Rebekah. Photo courtesy of Rebekah
Tomlinson Mendoza.
breakdown” and took the year off to rest; nevertheless, she graduated in 1937, and
went on to briefly play a concert tour.
During this time, Benjamin Tomlinson entered Lolo’s life, and she realized
traveling to play the concerts would separate them. To be closer to Ben, she gave up
the tour in favor of a teaching position with the Manning Public School system. This
position proved short lived, however, because she and Ben married in November
and settled in Georgetown.
Lolo Experiences Tragedy
Ben and Lolo’s first child, David, was born in 1940 and quickly became the
apple of Lolo’s eye. When she became pregnant just seven months later, however,
things began to change. Unable to handle her second pregnancy, she sent David to
live with his grandparents and aunt on the farm about a hundred miles away. After
she and Ben welcomed Rebekah into the family in 1941, David returned home.
Their bottom floor apartment in the
spacious Victorian home in the historic
district of Georgetown was now feeling
cramped, so Ben built the family a three-
bedroom concrete block home on Duke
Street. He later added a double car detached
garage that he used as a workshop, fenced
in the yard, and built a chicken coop where
the family raised about 40 chickens. What
eggs the family didn’t use, Lolo sold to the
neighbors.
In the front of the house was an
extra-large room where Lolo had her piano
and music cabinet. She gave private piano
lessons in her home, played the organ for
the local Baptist church, and performed at
various social functions. While she
functioned reasonably well, two traumatic
events soon threw her world into a tail spin.
Sally J. Ling
188
The first came in 1942, when Lolo had a hysterectomy, ending her ability to
conceive more children. As no hormone replacement therapy was then available, she
had a difficult time coping both physically and emotionally with the distressing
event. Showing signs of mental instability, she was sent for shock therapy; however,
she was given only one treatment as it was thought any more could cause permanent
brain damage.
During this time, Lolo’s behavior was beginning to take its toll on Rebekah:
“I was told many years later that I also had to see a psychiatrist. Daddy told me that
after one quick visit, the doctor thought it best to send me to the farm to stay a while
and that nothing was really wrong with me. Apparently I had a child’s reaction to
the way Mother was doting on my brother and not giving me what I felt was my
share of attention. She wasn’t bad in any way, just totally absorbed in trying to make
up for David being away from her as a little tot. I was told that I thought I had a
snake inside of my belly, and they couldn’t get me to wear any real clothes–only a
long loose gown. I was also told that within a week’s time at the farm, I was as
normal as any little child could be. I have absolutely no memories of any of these
events.”
For many years, Lolo functioned quite well and enjoyed family vacations to
nearby beaches, including Pawley’s Island, the mountains of North Carolina, and St.
Augustine. There were even times when David and Rebekah would stay with their
grandparents on the farm while Lolo and Ben took trips by themselves.
Unfortunately, the second traumatic event lurked just around the corner.
In 1947, Lolo’s father died of bladder cancer. Along with her inconsolable
grief, she suffered terrible guilt that affected her ability to deal with the everyday
decisions of running a household and raising children. According to Rebekah, Lolo
maintained a continual feeling of guilt because she never got the chance to pay back
her father for all the hard work he did over the years to make sure she had a college
education and proper musical training. The guilt and her inability to accept his loss
rendered the pain of his death overwhelming.
Believing a change in scenery would do the family good, Ben moved the
family to Tallahassee, Florida, in 1952. Lolo gave private piano lessons in the house
on Grace Street and gave organ lessons to people in their homes; but, her teaching
became sporadic and soon ended. While she functioned fairly well in many ways
continuing to drive and take care of the househer mental problems became worse,
and she began to exhibit behavior totally out of character. Opening up cereal boxes
to let the cereal breathe was just one example of her bizarre behavior.
Out of Mind, Out of Sight
189
Rebekah, now old enough to experience some of her mother’s inexplicable
behavior, recalled that one recurring problem had to do with sewing: “She would
take clothing apart and put it back together again in a slightly different way by hand
. . . She couldn't be trusted with scissors because she would cut all her clothes into
pieces. Later she would also cut her hair . . . She would walk into the room and say
things out of the blue then leave the room again. She would roam around the house
and make sort of grunting sounds or heavy breathing.”
Ben realized Lolo needed immediate professional help when one day, after
bringing the children home from school, he found a bowl full of wooden hammers
she had broken out of the piano. Said Rebekah: “She had turned on the one thing she
most loved–music. She had already lost interest in current events and I’m pretty sure
she was no longer a ‘wife’ to my father.”
Lolo Enters the Florida State Hospital
Two doctors declared Lolo incompetent due to chronic schizophrenia; and,
on June 26, 1957, she was committed to the Florida State Hospital at Chattahoochee.
Discharged after only a couple months of treatment, she returned home where she
remained for about a year. Rebekah recalled that at times her mother thought “they”
were trying to get the family to eat White House applesauce by talking about politics
on TV. The invisible “they were always around, even though no one knew who
they were.
On one occasion, Lolo accused Rebekah of flirting with her father. Another
time, she sold several pieces of furniture and replaced it with what Rebekah
described as some really weird stuff. While Ben managed to get most of the
transactions reversed, Rebekah felt it must have been horribly embarrassing and
difficult for her father. Lolo went back to the hospital.
On most weekends while Lolo was in the hospital, Ben, Rebekah and David
visited her. Rebekah remembered the white buildings that housed the patients at
Chattahoochee and the waiting rooms where most of their visits occurred:
They were clean and neat and I don’t remember any
objectionable smells like real hospitals sometimes have. I do
remember talking to some other patients some really
“interesting” folks. People padded around in slippers and
housecoats and many had “spacey” looks. I remember one time
Sally J. Ling
190
in a visiting room on the second floor looking down on a
courtyard where a number of patients and attendants were sitting
and walking around. One lady with very stringy hair was
standing facing the building toward me. She just stood there
constantly wringing her hands. To someone my age (about
twelve maybe), that was really bizarre. I also remember someone
who suddenly took off running from one side of the courtyard to
the other. Two attendants grabbed her, put a straitjacket on her,
and dragged her inside. They didn’t seem to be cruel, just firm
with the task at hand. That was probably the most bizarre thing I
had ever seen; and, of course, I’ve never forgotten it.
There were visits where Mother was as normal acting as anyone
I knew. Other times she seemed hyper or drugged. Even at my
tender age, I could tell that where she was housed at the hospital
was different each time she went back, and each change put her
in a less “sane” place. She had progressed from the really
hopeful area, the “going to go home soon” area, to the custodial
care section. The buildings were progressively older and less
inviting.
Lolo was furloughed back to her home, but by this time her behavior was
taking its toll on Rebekah, who was now in college. Rebekah said she couldn’t study
at home or spend the necessary time at the Florida State University library. She
changed her major to make it easier to get a degree, but said “it just wasn’t fun
living at home with Mother and trying to go to college at the same time.”
In 1960, Rebekah joined the Navyher way of running away from home
and her Mother. When she returned to Tallahassee in 1961 to get married, Ben
decided to send Lolo back to Chattahoochee. This time, there was little hope of her
ever returning home to live a normal life as wife, mother, and grandmother. In 1964,
Ben divorced Lolo and later remarried.
Rebekah returned to Tallahassee with her daughter in 1969 after her own
divorce, and took over Lolo’s care from her father. On her visits to Chattahoochee,
Rebekah would typically take Lolo for drives off hospital grounds and to a local
restaurant for lunch and for talks.
Out of Mind, Out of Sight
191
Lolo Returns to the Family Farm
In 1972, when the Florida State Hospitals began transitioning patients into
foster care programs, Lolo was released to the care of her sister Martyn who lived
on the old family farm in South Carolina. With this move, everyone had high hopes
that Lolo’s being back in familiar surroundings with her family would prove of great
benefit. Martyn, however, had never really understood the depth of Lolo’s mental
problems and, in fact, had placed much of the blame for them on Ben.
Misunderstanding the instructions the hospital doctors gave her for Lolo’s
care, Martyn discontinued her sister’s medication. It wasn’t long before Lolo
relapsed. This forced Martyn to acknowledge the severity of her sister’s condition
for the first time.
Martyn begged Rebekah to come get Lolo because she was making life
miserable for the family by being bossy, belligerent, and pacing the floors. In
addition, Lolo insisted that neither Martyn nor the children play the piano. This
proved a major problem because Martyn played for Hebron Methodist Church and
needed to practice. When Rebekah picked up Lolo, Martyn implored her to please
tell Ben she didn’t blame him anymore and was very sorry for thinking he had been
the cause of Lolo’s mental condition.
Once Lolo’s condition stabilized, she was furloughed again, only this time
she went to the private home of Mrs. Clyde Gilbert in Quincy, Florida. The small
home worked out well until Gilbert’s failing health required Lolo to be moved to
another facility. Again, failing health on the part of the caregiver forced Lolo to
move a third time to Ruby Varnum’s house (Varnum's Rest Home, as it later
became known) where Ruby cared for several other ladies. Lolo was with Ruby for
over 20 years.
Of her Mother’s time in foster care, Rebekah noted that Lolo still exhibited
abnormal behavior: “She cut out things from magazines and saved them, then gave
them to me. This started when she was in hospital but continued for a number of
years in foster care. We're talking about an entire grocery sack full of pictures and
adsmostly about food or beauty products. There were times she didn't want to
wear shoes (she would wear socks) because she thought they were bad for her feet.
Rebekah became Lolo’s legal guardian in 1984; and, while Ben allowed
Rebekah to make all decisions regarding Lolo’s care, he was always concerned
about her. He made sure that Rebekah always had enough money to provide Lolo
with decent clothing and meet her other needs. He also planned for her funeral
Sally J. Ling
192
Eleanor “Lolo” Woodham Tomlinson. Photo courtesy of Rebekah
Tomlinson Mendoza.
expenses if she died before he did. Until Ben’s death in 1988, of a heart attack at age
75, he and Rebekah visited together every few days and always discussed Lolo’s
care and progress.
Lolo’s Last Days
Macular degeneration, two broken hips, and dementia slowed Lolo in the
end, but her bright outlook never dimmed. Even when told that her sister had died,
Lolo simply replied, I'll cry later.”
She spent the final year of her life at Blountstown Health and Rehabilitation
with her last week under the care of Covenant Hospice. Rebekah read Psalms to her
just before she left this world on Monday, December 1, 2008, at the age of 93. Later,
when friends and family gathered to say their final goodbyes at Hebron Church in
South Carolina, Lolo looked lovely in her pale pink gown with dainty floral
embroidery at the neckline and a matching robe. A small white Bible rested in her
hands along with a few photographs of her family.
Lolo was laid to rest in Hebron cemetery beside her beloved sister in the
“bosom of the Woodham family heart” while one of her favorite hymns, “Jesus
Loves Me,” wafted on a breeze. The Reverend Julius Haddon officiated at the
graveside service while Reverend Ed Wilkes, dressed in full Scottish regalia, played
“Amazing Grace” and “Going Home” on his bagpipe.
Out of Mind, Out of Sight
193
The Rest of the Story
One might think that would be the end of Lolo’s story, but it’s never that
simple when one lives with a mentally ill family member. It wasn’t until decades
later, with the help of therapy, that Rebekah was finally able to recognize and cope
with the anger she harbored as a result of feeling abandoned by her mother at such
an early age: “Mother left me (yes, she was ill and not her fault) . . . Anyway, I
discovered I was angry with her even though I loved her very much. I suppose
knowing that helped me. I don't think it affected the way I acted when I was with her
- don't think I ever displayed any ill feelings towards her.”
Many who live with a loved one who is mentally ill wonder if they will
suffer the same fate. Rebekah wondered that too: “The thought has, of course, come
to mind, but I've never seriously dwelled on it. I think I've feared the most that it
might skip a generation or two and show up in my daughter or one of the
granddaughters. However, my daughter is mentally healthy.”
477
Sally J. Ling
194
Out of Mind, Out of Sight
195
APPENDIX
TIMELINE
1814-1817 First Seminole War
1817 Scott Massacre
1821 Spain Cedes Florida to the U.S.
1823 Gadsden County is established
1828 First Post Office established at Mount Vernon
1830 Indian Removal Act
1832 Captain Hills surveys land at Mount Vernon
1834 Mount Vernon name changed to Chattahoochee
Apalachicola/Chattahoochee Arsenal begins construction
1834-1842 Second Seminole War
1839 Arsenal opens
1855-1858.1 Third Seminole War
1861 Florida Cedes from the Union
1861-1865 Civil War
1865 Arsenal becomes Freedman’s Bureau
1868 Florida State Prison established at Chattahoochee
Malichi Martin becomes first warden
Calvin Williams becomes first prisoner
1870 Betsey (Betsy) Yulee arrives at state prison as first insane resident
1877 Prisoners moved to work camps
Prison becomes Asylum for the Indigent Insane (Lunacy Law)
Sally J. Ling
196
1886 Name changed to Florida Hospital for the
Insane
1900 Name changed to Florida State Hospital
1905 Asylum Scandal of 1905
1910 Hydrotherapy established as standard treatment for mentally ill
patients
1919 Opening of Nurses Training School
1921 First Epileptic Colony established in Gainesville
1926 Influenza Epidemic
193? Dr. Marynia Farnahan Inspection and Survey
1930s Introduction of Fever Therapy, Insulin Shock Therapy, Metrazol
Shock Therapy, and Electroconvulsive Therapy (ECT)
1934 Dr. William DeWitt Rogers arrives at FSH
1935 Prison Camp established at Florida State Hospital
1936 Dr. Walter Freeman and Dr. James W. Watts perform first
lobotomy in U.S.
1937 Dr. James G. Lyerly performs first lobotomy at Florida State
Hospital
1940s 9-hole Thronateeska golf course built at Florida State Hospital
Groundwork laid for community-based treatment
1940 Dr. William DeWitt Rogers becomes clinical director of FSH
1941 Rosemary Kennedy receives lobotomy
1946 Dr. Freeman performs first “ice pick” lobotomy
National Mental Health Act passed
1947 G. Pierce Wood State Hospital in Arcadia opens
1949 National Institute of Mental Health established
1950 Dr. William DeWitt Rogers becomes superintendent of Florida
State Hospital
1951 Child Molestation Act passed
1955 FDA approves use of chlorpromazine (Thorazine)
Out of Mind, Out of Sight
197
1956 Kenneth Donaldson sent to Florida State Hospital
1957 Establishment of Florida Division of Mental Health
1958 Opening of South Florida State Hospital in Hollywood
1959 Opening of Northeast Florida State Hospital/Macclenny
Admission by order of Certification established
1960s Integration of Florida State Hospitals
1961 Committee on State Institutions conducts investigation of Florida
State Hospital
Dr. William DeWitt Rogers becomes director of Florida's Division
of Mental Health
1970s Move to deinstitutionalize mental health care
1972 Baker Act established
1973 Forensic hospital opens at Florida State Hospital
1975 Kenneth Donaldson wins U.S. Supreme Court Case
1976 Florida State Hospital establishes mortuary
Kenneth Donaldson’s book released – Insanity Inside Out
1986 Seminole Valley Golf Club opens on Florida State Hospital grounds
U.S. Supreme Court rules that the Eighth Amendment prohibits
states from inflicting the death penalty upon prisoners who are
insane
1991 Movie “Chattahoochee” released in theaters
1995 Seminole Valley Golf Course closes amid scandal
1996 Department of Children and Family Services (DCF) established
1999 Florida State Hospital receives Governors Sterling Award for
Organizational Excellence
2002 G. Pierce Wood State Hospital in Arcadia closes
2009 & 2012 Florida State Hospital at Chattahoochee receives three-year
accreditation
Sally J. Ling
198
UNUSUAL CAUSES OF DEATH AND NOTEWORTHY
CIRCUMSTANCES - 1933
Name
Date
of
Death
Duration
of
admission
Admission
Diagnosis
Age/
Race/
Gender
Cause of Death
Isabelle
Miranda
1/19/3
3
22 y, 1 m
Main Dep.
Psychosis
62 white
female
Gangrene arm-
Diabetes Mellitus
Ludwig’s Ang
Henrietta
Henne
1/19/3
3
1 y, 7 m
Manic Dep.
Psychosis,
Menopause
49 white
female
Self-inflicted
hanging
Mathew
Carlton
1/19/3
3
12 years
Feebleminde
d with
psychosis.
Deteriorated
54 white
male
Fracture of skull;
accidental
Lizzie
Dixon
1/21/3
3
34 y, 1 m
Epilepsy
with
psychosis
70 white
female
Pul. Tb. Chronic
amoebas & colitis
Henry
Lee
1/30/3
3
39 y, 8.5 m
Dementia
Praecox
62 black
male
Influenza.
General
Septicemia.
Ludwig’s Ang.
Minnie
Davis
2/3/33
19 y. 1 m.
Dentia
Praecox
45 black
female
Died suddenly
cause
undetermined
Richard
Edwards
3/1/33
18 y, 10.5
m.
Dementia
Praecox
42 black
male
Cerebral
hemorrhage
Jimmie C.
Johnson
3/13/3
3
35 y., 11 m
Feebleminde
d
84 white
male
Chr. Nephritis.
Crh. Myocarditis,
Cardiac
Decompensation
Laura
Snow
4/24/3
3
31 y., 7 m.
Senile
Dementia
84 white
female
Chr. Myocarditis,
Arsenical
Dermatitis
Out of Mind, Out of Sight
199
Mamie
Lumley
6/4/33
20 y., ½ m.
Dementia
Praecox
43 white
female
Inf. With
gangrene thigh
general debility.
Ysolina
Noa
7/23/3
3
4 y., 1½ m.
Dementia
Praecox
28 white
female
Died suddenly,
cause
undetermined
Barbara
Arbeau
7/25/3
3
2 y., 4 m.
Menopause
with
psychosis
44 white
female
Bronchial
pneumonia,
Pellagra
Marion H.
Hammock
7/30/3
3
37 y., 4 m.
Dementia
Praecox
73 white
male
Acute Catarrhal
Jaundice
Gus
Rathers
8/15/3
3
10 minutes
Undetermine
d
31 black
male
Undetermined
Mary
Hawkins
9/5/33
39 y., 10 m.
Feebleminde
d Senility
w/Psy.
62 black
female
Cere.
Hemorrhage
William
Fuller
10/8/3
3
16 y. 2 m.
Feebleminde
d
66 black
male
Pul. Tuberculosis
Ellison
Cleveland
10/9/3
3
1 day
Mental
Exhaustion
43 black
male
Exhaustive
psychosis
Rueben
Wilson
10/15/
33
22 y., ½ m.
Epilepsy
w/psychosis
31 black
male
Pul.
Tuberculosis, Pul.
Thrombisis
Julia A.
Jones
10/28/
33
17 y., 6 m.
Epilepsy
51 white
female
Status
Epilepticus
H.N.
Carter
11/12/
33
4 y., 6½ m.
Cer. Spi.
Syphilis
44 white
male
Fractured Skull
Sally J. Ling
200
1933 Child Admissions under the age of 15.
None discharged.
478
Floriene Peterson, 10 year-old black female, admitted by
court order on 4/15/33 with admission diagnosis of “Feebleminded.”
Discharge book shows she was discharged 6/13/33, “Unimproved.”
A. H. Bracewell, Jr., 7 year-old white male, admitted by
court order on 6/16/33 with admission diagnosis of “Congenital Iddicy.”
(sic)
Raymond Moore, 7 year-old black male, admitted by court
order on 6/6/33 with admission diagnosis of “Observations” (Probably
Traumatic Psychosis/Epilepsy).
Irvin Albert Ingraham, 14 year-old black male admitted by
court order 6/19/33 with admission diagnosis: “Idiocy.”
Ruth Davis, 12 year old black female admitted 7/4/33 with
admission diagnosis: “Feebleminded.”
Sammie McKee, 14 year-old white male admitted on
10/1/33 with admission diagnosis: “No Psychosis.”
Out of Mind, Out of Sight
201
FLORIDA STATE HOSPITAL
STATISTICS 1878-1968
Year
Patients
Adm
Fur
Disch
Died
Escaped
Empl
1878
86
19
12
1884
157
1887
183
1890
239
64
0
38
35
Jan-00
N/A
1892
272
104
0
27
51
0
N/A
1893
277
106
0
34
59
Jan-00
N/A
1894
306
132
0
69
29
Mar-00
N/A
1895
288
60
0
38
39
0
N/A
1896
373
171
0
51
35
Mar-00
N/A
1897
443
175
0
51
51
3/unknown
N/A
1898
491
230
0
87
92
3/unknown
N/A
1899
561
221
Unknown
79
69
3/unknown
N/A
1900
612
219
Unknown
70
94
0
N/A
1901
640
274
Unknown
113
118
4
N/A
1902
697
286
25
126
102
1
N/A
1903
734
237
Unknown
90
104
6/unknown
N/A
1904
747
305
Unknown
133
146
13/unknown
N/A
1905
752
248
57 (included
in total # of
patients)
142
99
0
N/A
1906
802
257
85 (included
in total # of
patients)
109
97
1/unknown
N/A
1907
730
318
113
128
134
Aug-00
N/A
1908
794
298
126
96
119
2-Apr
N/A
1910
929
329
145
119
120
3-Aug
Approx.
180
Sally J. Ling
202
1912
1,107
381
70
280
194
12/unknown
N/A
1914
1,336
590
154
212
202
5/unknown
Approx.
200
1916
1,482
563
101
288
238
0
N/A
1918
1,403
659
146
233
475
17/9
294
1920
1,538
669
234
154
241
64/41
N/A
1922
1,910
698
149
104
240
74/43
N/A
1924
2,266
891
219
130
386
83/55
N/A
1926
2,490
974
322
156
413
108/63
N/A
1926-1928
2,973
2,271
796
281
851
209/138
N/A
1928-1930
3,407
2,597
858
485
892
372/203
N/A
1930-1932
3,706
2,540
1,008
483
845
244/162
N/A
1932-1934
4,011
2,352
985
392
893
183/118
Approx.
700
1934-1936
4,012
1,575
804
261
663
169/94
800+
1936-1938
4,268
1,782
849
194
583
108/65
848
1938-1940
4,613
1,608
786
164
599
115/70
888
1940-1942
5,015
2,086
1,202
142
638
126/65
950
1942-1944
5,203
1,833
1,239
132
830
131/102
793
1944-1946
5,390
1,858
1,295
110
799
101/74
865
1946-1948
5,243
2,359
1,405
139
796
113/78
944
1948-1950
5,729
3,161
1,402
133
768
104/82
1,123
1950-1952
6,223
3,286
1,616
158
728
107/66
1,481
1952-1954
6,490
3,524
1,865
175
727
100/66
1,634
1954-1956
6,521
4,231
2,399
321
897
83/45
1,763
1956-1958
6,680
4,457
2,514
390
957
104/63
1,859
1958-1960
6,396
4,397
2,936
641
899
77/51
1,919
1960-1962
6,106
4,468
2,732
872
960
99/66
1,941
1962-1964
5,929
4,166
2,331
947
896
128/70
2,269
1964-1966
5,646
4,605
2,618
1,155
942
149/92
2,303
Out of Mind, Out of Sight
203
1966-1968
5,309
4,318
2,373
1,091
1,025
115/77
2,430
NOTE: No records were available after1968.
Sally J. Ling
204
INSPECTION REPORT OF THE
FLORIDA STATE HOSPITAL 193-?
The following is a condensed version of an inspection of the Florida State
Hospital made by Dr. Marynia Farnhan sometime in the 1930s
The full report may be found online at:
http://freepages.genealogy.rootsweb.ancestry.com/~chattahoochee/Farnhan.htm.
General Overview
The organization of the Florida State Hospital included several
divisions made up of: administration, maintenance, receiving and treatment hospital,
tuberculosis infirmary, dental infirmary, general infirmary for the chronically
disabled among the white patients, and four units that housed the white female,
white male, colored female and colored male patients.
Averaging 100 admissions per month, patients entered
Chattahoochee via the receiving hospital where they were held for 30 to 60 days
before being assigned to general wards. The receiving and treatment hospital itself
consisted of wards to care for the acutely ill of both colors and sexes along with an
operating room, laboratories and x-ray department. During admittance, four
attending physicians, registered nurses and nurses in training conducted thorough
examinations to determine the patient’s mental and physical condition. Histories, if
available, were obtained from the patient or relative, and a diagnosis, both physical
and mental, was made. This was followed by an appropriate treatment plan that was
outlined before the patient was transferred to a ward.
479
After examination, patients were assigned to wards that were divided by sex
and ethnicity. Letters or numbers, in ascending order, further divided each ward and
patients were assigned to these as determined by their “symptomatology,” or level of
physical and mental competency.
Wards consisted of individual rooms with from two to four beds apiece and
a communal porch for gathering. In most wards however, beds replaced space on the
porches because of the severe overcrowding. Generally, the patients seemed well
cared for and the number of nurses sufficient. The general appearance was one of
“cleanliness and order and every effort is made to give the patients proper and
considerate treatment within the limitation of the institution itself.”
480
Out of Mind, Out of Sight
205
Additional wards servicing both sexes and colors included those devoted to
malarial treatment of central nervous system syphilis. Under the direction of Dr.
Mark Boyd of the Malarial Experimental Station that was operated by the
Rockefeller Institute, patients were inoculated with a variety of malaria treatments.
Because no treatment was available in the general wards for patients who
were in the most seriously disturbed and violent mental condition, the receiving and
treatment hospital accepted and housed these patients. This resulted in those with
acute physical illnesses and acute maniacal phases of mental illness being placed
together. On the day Farnhan made her the preliminary visit, she reported that six
seriously mentally disturbed patients were causing pandemonium in the white
woman’s ward of the receiving hospital. So disruptive were their screams that the
other patients, many of whom were recovering from surgery or convalescing from
illnesses, were unable to get any rest, thus extending their recuperation.
481
Besides the wards being overcrowded and the mix of patients within each
ward less than ideal, privacy in the wards was nonexistent. In the white female ward,
dressing, undressing and bathroom needs were all performed in one common area
with no privacy at all, a condition that pervaded each ward in the hospital. Five
communal showers located just a few feet from the washbasins and toilets, some
with no seats, forced patients to bathe while others used the facility. Concrete floors
were damp and hard to keep clean, and showerheads and water pipes leaked causing
the pipes to rust.
482
In this ward, as throughout the hospital, beds were so close together that a
patient trying to reach his or her bed would find it impossible without either moving
the entire line or crawling over those in the way.
Patients who could work were assigned duties according to their
capabilities. Those who were more disturbed and unable or unwilling to work were
allowed outside in a fenced yard. On inclement days they spent time on the porches,
lay in their beds, on the floor under their beds or curled up and scattered throughout
the ward.
Attendants were, for the most part, untrained yet it was noted that
throughout the visit that there was never any evidence of mistreatment of the
patients here and none showed any evidence being afraid of the attendants.
483
Sally J. Ling
206
Tuberculosis Hospital
It was widely known that blacks were particularly susceptible to
tuberculosis and common sense would have dictated that patients in the “colored
wards” who had this disease would have been quarantined in order to control its
spread. At Chattahoochee, however, that was not the case. In fact, it was quite the
opposite.
In the tuberculosis ward of the Receiving Hospital, Farnhan reported that
the porches in the “colored wards” only had simple screen doors to separate
tuberculosis patients from the general population and no provisions to quarantine
those near death into separate rooms. And because there were so many infected
black patients, the remainder were scattered throughout the wards to spread the
infection throughout the general population.
484
Wards
As noted before, wards were segregated by ethnicity, at the time an
acceptable practice in every medical or mental hospital in the country. And
generally the treatment black patients received was inferior to that of white patients.
This policy did not change until desegregation during the mid-1960s, as noted later
in this book.
White Female Wards
The white female population of 1, 670 was housed in an old frame building
with sprinklers but no fire escapes. Attendants worked 12 hours a day, six days a
week for a wage the report called “pitifully inadequate.” Yet the workers appeared
caring and of generally high character despite the fact that none of them had been
trained, except for what they acquired on-the-job in the Wards.
All the Wards were quite similar in physical layout with dormitory style
sleeping arrangements, attached sanitary facilities and a porch that could be
accessed from all parts of the wards. Outside, a large grassy area surrounded by a
fence contained various sized shelters with benches. These were available for the
patients when weather permitted, however, during the summer patients were only
allowed outside during early morning or late afternoon due to the relentless heat.
Severe overcrowding existed in all the wards with some beds only four to six inches
Out of Mind, Out of Sight
207
apart. In many cases, this required the patients to climb over several beds in order to
reach their own.
485
Patients in Ward A had the best physical condition, were the least disturbed
and the most cooperative. Those who were able to work did so with assignments in
the dining, linen and art rooms, industrial shop, outside yard or other general
housekeeping duties such as bed making and cleaning.
486
A moderately sized
attractively furnished day room with books, writing space and comfortable chairs
was shared by patients from Ward A and J.
As the letter of the ward got higher, the patients’ mental and physical ability
showed less capability. Ward F, for example, housed many patients who could not
control their bodily functions. On the day of the inspection, mattresses being aired
were described as extremely filthy with odors commensurate with the soiled
bedding.
487
In Ward G five attendants cared for 105 severely declining patients who
needed constant attention. Included among this group were seriously deteriorated
epileptics who could not maintain body cleanliness or control excretory functions.
This required attendants to change their clothes up to five times per day. Other
patients were destructive to furnishings and clothing and were constantly restrained
by camisoles or tied to chairs or beds except for exercise twice a day.
488
Farnahan noted that the epileptic patients in this ward were of the most
seriously deteriorated type. Here, patients spent a large portion of their time in
restraints, were fed, sometimes forcibly, soiled themselves as well as their clothing
and surroundings, and continuously inflicted injury on themselves and others if
given the slightest opportunity. Other less disturbed patients were subjected to
frequent attacks by those who were more disturbed if they were not closely
watched.
489
Ward L contained 48 patients commonly referred to as “maniacs.” These
were the seriously disturbed patients with dementia praecox and manic-depressive
behavior. These patients constantly screamed, attacked the furniture or were violent
toward other patients. This resulted in many being placed in restraint or sedated
during violent episodes. Farnhan described the disturbance in this ward as intense
with a loud buzz, punctuated by frequent shouts and screams, that could be heard a
considerable distance from the building.
In this ward frightening brutality” between patients was
commonplace and was met with equal brutality by the attendants. Some of the
Sally J. Ling
208
violence witnessed included patients attacking each other with the attendants having
to drag the offender off by the hair in order to control her until placed in a camisole.
This, the report noted, was because there were too few attendants to make anything
else possible.
490
Two hundred physically debilitated patients were housed in Wards O, S, and
T including those with cerebral hemorrhages (strokes), hypertrophic arthritis and
other chronic incapacitating diseases associated with later life. While some of these
patients were unclean, uncooperative, and sometimes violent, many were in
wheelchairs. These patients, the report stated, could have been cared for in boarding
homes or by family members at home had there been the desire and/or facilities to
do so.
491
While most of Farnhan’s findings were somewhat expected given a facility
of this type, she was most stunned to find a normal male child of three living in a
white female ward among the acutely physically ill and several intensely violent and
disturbed patients.
The mother, who was pregnant at the time she was brought to the hospital
for treatment by the father, was taking care of the child since locating the father had
been unsuccessful. According to the hospital, the toddler was there only after every
effort was made to place him elsewhere and the child’s county of resident refused to
take responsibility.
492
Colored Female Wards
Numbers C-10 to 22 were used to designate the colored Female Wards that
housed a total of 671 patients. Four wards each were housed on three floors, with
each floor being considered a unit. The report stated that despite the wards being
fairly clean, immediately upon entering these wards it was apparent that the
handling of the “colored” female patients was inferior to that of the white female
patients, and that attendants were inferior as well. Twenty-eight day attendants and
15 night attendants cared for the patients with many on “detail duty,” taking patients
to and from outside work, and to and from treatments. This reduced the number of
attendants who were actually on the floor at any given time.
These wards did not have a recreation room but they did have a yard, though
it was less adequate and notably less pleasing than that of the white Female Wards.
Clothing worn by the colored Female Patients was of decidedly poorer quality than
Out of Mind, Out of Sight
209
that issued to the white females, with many patients wearing “ragged and patched
clothes and some being extremely dirty.” This, it was explained, was because it was
“impossible to keep some patients clean, regardless of the efforts . . .”
493
Wards C-11 to 14 contained 196 women, many of who were pellagra
patients and had a deficiency in niacin (vitamin B3). These patients were not
allowed outside and were given special pellagra diets. Also on this floor was a nine
year old feeble-minded child who had been on the ward since infancy.
494
Wards C-15 to17 contained the poorer class of patients who were more
deteriorated. As in the white Female Wards, the higher the ward the more
deteriorated the patient with the exception of C-10. This ward, housed in the
basement, was reserved for the physically incapacitated and senile patients, many of
whom were untidy and entirely helpless, requiring constant care.
495
White Male Wards
Patients in the white Male Wards numbered 1,183. Wards one to 10 were
configured similarly to those of the female wards where again, overcrowding was
severe. With no beds on the porches, however, this left no space between the beds
but only a center aisle. The men had two yardsone for the better class of patient
and one for the more deteriorated and violent patients. These yards were decidedly
less pleasing in appearance with shacks scattered here and there as shelter from the
sun. Steep downhill slopes were hazardous and the fence surrounding the yard was
inadequate to prevent escapes, which appeared to be rather routine.
There was no recreation area and only one small sitting room on the main
floor for visitors. During inclement weather the patients weren’t allowed outside and
simply sat about where ever they could find space. Several hundred of the patients
worked on the farm, or in the kitchens, laundries, mattress factory or various
maintenance shops, always accompanied by an attendant. Use of restraints was
liberal and at the discretion of the Chief Attendant.
496
A physician, in attendance on the ward at all times, was responsible for the
care and treatment of minor illnesses and injuries. Answering correspondence and
examining patients about whom there has been an inquiry was the responsibility of a
second physician.
497
Sally J. Ling
210
Colored Male Wards
The colored Male Wards, numbered 1-11, had a population of 740. Of
those, 297 were employed in various capacities throughout the hospitallaundry,
construction and building repairs, engine and boiler rooms of the heat and power
plants, kitchens, dining rooms and other maintenance of the hospital. The housing
was especially deteriorated with floors sagging and two side wards showing signs of
collapsing inward, and although these wards held fewer patients, they were no less
crowded than those of the white Male Wards.
498
The old and feeble were housed in
ward 11. Also called “the nursery,” this ward housed 11 young children, all of
whom were feeble-minded with “several of the idiot grade.”
Restraint, in the form of leather cuffs as well as chains, was widespread in
these wards due to so few attendants. Although Farnhan saw no evidence that the
patients suffered more from the use of chains than leather cuffs, she was very much
opposed to their use believing that the psychological effect of using chains was
demoralizing and correlated to prison and punishment.
499
The attendant in charge of the nursery was also in charge of an adjoining
ward containing 23 criminally insane patients. Here, restraint was used liberally;
but, an additional method of discipline was also included, one reminiscent of the old
prisona sweatbox. While there was no sweating, unmanageable patients were
locked in this container where it is impossible to lie down.
Unlike the other wards, certain patients in the “Colored” Male wards were
allowed to wander the grounds with almost entire freedom. One patient with
dementia praecox (schizophrenia) who was in charge of the institution’s coal
burning did not finish his work until 10 or 11 at night but was allowed to come and
go freely from his job without an attendant, even though he was considered
“dangerous and unfit for discharge.”
There was no physician assigned to this ward, however one of the doctors
did make daily rounds to check on patients who were ill and requested interviews. A
small inadequate treatment room serviced minor illnesses and/or injuries, a number
that was unusually large.
500
The Infirmary
This facility was a two-story frame building with porches on all sides. It
housed both male and female white patients who required constant care but did not
Out of Mind, Out of Sight
211
require hospitalization. These patients included those who were paralyzed and who
were unable to feed or dress themselves or had late stage cancer or severe diabetes.
Two “feeble-minded” children were found in this ward, neither of which was
psychotic. Attendants, under the direction of a registered nurse, rendered care.
While there appeared to be ample room to keep beds inside in the male ward
year round, during winter months the beds were moved to the porches so patients
could sit inside. In the summer, this situation was reversed. As temperatures during
winter could drop down to freezing, it seems odd that the beds would be positioned
outside during these months; however, there is no indication to the contrary.
Bathrooms were inadequate with two tubs for the women and two showers
for the men. Bedridden patients in the male ward had to be transported into the
showers via wheelchairs and bathed accordingly as there were not enough attendants
to do it any other way. Meals were brought in from the kitchens, but there were no
provisions to keep the food warm and it was described by Farnhan as unpalatable.
501
General Administration and Management
The hospital operated under the direction and supervision of a
Superintendent who was not a physician and did not have any former experience in
a similar facility. The superintendent managed all areas from operation of the 8,000-
acre farm to purchasing and patient work assignments. Everything was under his
direction supervision except for matters of patient care. That he deferred to the Chief
Physician and his staff of doctors.
Farnhan found the Superintendent’s nonmedical background and the
emphasis he put on fiscal operations detrimental to the curative nature of the
institution. Though she acknowledged he was considerate of the patient’s welfare
and happiness, she felt that his lack of medical training and knowledge of mental
illness failed to provide the skills necessary to give effective direction to the
institution.
502
She was also critical of the program that allowed patients to work in various
capacities around the hospital, believing it was a two-edged sword. The staff, she
suggested, would be reluctant to discharge patients who performed work essential to
the operations of the hospital, a feeling also expressed by the patients. And she
believed the patients could become dependent upon institutional life and would be
reluctant to accept the challenges of a normal community.
Sally J. Ling
212
Farnhan’s goal was not to eliminate the program but to move it under the
direction of a physician instead of the Superintendent. She emphasized that: “Since
it should be regarded as a portion of the patient's treatment, it should inevitably be
undertaken under the direction or delegated direction of the physician in charge of
that patient.”
503
Another area found to be of concern was the food, which she called inferior
grade and without proper balance. Meals, planned by a steward, approved by the
Superintendent and then passed onto the Chief Physician for review, were found to
have excessive use of starches and syrup while almost devoid of fresh fruits. One
menu she cited included beef stew, Irish potatoes, grits, macaroni, light bread and
syrup.
Because some types of mental illness caused a reduction in appetite and it
took great tact and persuasion by the attendants to encourage the patients to take an
interest in their food, Farnhan noted that making sure the menus were balanced was
paramount to maintaining the patient’s best health. But food selection wasn’t the
only problem. Service in the dining room was called “extremely bad” with food
being served in the “crudest and most revolting fashion by being slopped onto
battered tin trays.”
504
Medical Care and Supervision
Under the direction of the Chief Physician, nine physicians, including the
Chief, performed all the duties at the hospital for the almost 4,000 patients and 1,000
employees. Farnhan called the ratio of physician to patient “clearly ridiculous,” and
blamed this for the reason many patients could not be seen for years at a time.
Looking at the responsibilities of these men, one can only agree:
Chief Physician Oversees all patient care; performs or directs all major
surgeries; supervises 11 attendants and nurses; provides medical and surgical care to
those who are not mentally ill but who have been admitted to the hospital.
Physician A Assigned to the white female patients in the receiving
hospital, the general and tuberculosis hospitals; conducts clinics regarding
the treatment of venereal diseases to the white female patients; cares for the
white female employees; instructs the nurses.
Out of Mind, Out of Sight
213
Physician B Assigned to the white male patients in the receiving and
general hospital; manages the clinics for white male patients; cares for white
male employees; treatment of white male convicts.
Physician C Assigned to the colored female patients in receiving and
general hospital; care of black female employees; care of patients in the
colored Female Wards and correspondence regarding those patients; all
minor surgery and fractures of all patients of both sexes and colors;
conducts clinics in the treatment of syphilis for the colored female patients;
emergency surgery among convicts and employees as well as citizens
brought in off the highway due to automobile accidents. (The hospital was
the only one in the area.)
Physician D Assigned to the colored male patients in receiving and
general hospitals; care of colored male patients in the wards as well as
employees; correspondence regarding patients; care of 40 colored convicts
from the State Prison Farm, urological work for all patients of both sexes
and colors; conducts syphilis clinics for colored male patients.
Physician E Routine treatment of white female patients in wards and
correspondence; care of white female attendants, nurses and nurses in
training; assists Chief Physician in all major surgery; physical exams for all
new white female attendants and nurses; assists in all urological work.
Physician F Charge of correspondence regarding white male patients;
general supervision of the white male wards; care of white male convicts;
administers all general anesthetics in the hospital; operation of the X-ray
department; camp physician for 42 white male convicts located at the
hospital prison camp.
Physician G Specialist in diseases of the eye, ear, nose and throat of all
patients of both sexes and colors; performs routine duties when other
physicians are off.
Physician H Continuous attendance at the white male wards and treatment
of minor illnesses and injuries; examines all new white male attendants,
white kitchen and dining room workers.
In addition to the physicians, dentists provided care to the patients,
employees and 440 boys at the Industrial School at Marianna.
505
Sally J. Ling
214
Despite the overloaded schedules the report praised the physicians for their
dedication and ability to medically care for the patients under such difficult
circumstances. Farnhan noted, however, that there was a clear lack of accurate and
continuous patient record keeping. This resulted in an incomplete picture of the
individual patient’s condition and led to the patient not being adequately
evaluated.
506
While the Florida State Hospital was primarily designed for the treatment of
the mentally ill, it evolved into more of a medical hospital, as according to Farnhan
treatment of the mentally ill was almost nonexistent, except for an inadequate
hydrotherapy set-up for the white male patients. Occupational therapy, previously
mentioned as part of acceptable treatment, was also inadequate and lacked direction.
Psychotherapy, key to patient recovery and discharge, was also noticeably
lacking, though Farnhan did acknowledge that the physicians’ schedules didn’t
permit adequate time for this. And even if time was available, the hospital lacked
sufficient private space for these sessions to take place. This left the patients to
muddle their way alone, resulting in delayed discharges that cost the State a tidy
sum.
507
Recommendations
In spite of the deficiencies noted in the report, Farnhan concluded that the
institution was relatively clean and maintained a certain amount of order. The
patients were treated kindly but medical supervision was insufficient for the
physicians to become familiar with a patient’s state of mind or in any way contribute
to his/her recovery and possible discharge. She felt the staff was most conscientious
but worked under “crippling handicaps” that resulted in their being unable to render
the type and amount of care needed to assist the patient in his/her recovery.
Farnhan completed her report with a list of recommendations and hoped the
Legislature would provide the necessary funds to upgrade the facility and attract
qualified personnel who could help the state’s mentally ill citizens return to
productive lives. Her recommendations included:
Physical Facility - An aggressive building program to provide more
housing, reorganizing the units to better accommodate those patients who
are disturbed, new hydrotherapy equipment, office space for physicians for
psychotherapy, larger, more pleasant outdoor areas and new laundries
Out of Mind, Out of Sight
215
Personnel Additional personnel hired in all areas, enough
physicians to allow physician/patient ratio to become 1/150, increased
wages, hiring of physician specialists and psychologists, hiring of a
recreational director, hiring of a hospital record historian
Superintendent Employment of a physician as Superintendent of
the Hospital who has at least five years of experience in the care of the
mentally ill, moving the current Superintendent into a Business Manager
position
Occupational Therapy Establish an Occupational Therapy
department with a director and staff trained in this area
Social Services Establish a Social Services department with
director and staff
Diets Meal planning should be placed under the direction of a
dietitian
Medical Library Establish a medical library
508
Sally J. Ling
216
INTERVIEW WITH
MRS. MARY ROGERS
This interview with Mary Rogers, 92, wife of Dr. William Rogers after
whom the William DeWitt Rogers Administration Building was named, was
conducted in Mrs. Rogers home in Chattahoochee by Florida State University
intern and research assistant Tara Benton Newman in 2009. Rogers was staff
physician from 1934-1940, chief physician from 1940-1950, superintendent from
1950-1962, and director of the Division of Mental Health for the State of Florida
from 1962-1974.
Q. Where are you from originally?
A. Cantonment, Florida, but I graduated high school in Waycross, Georgia,
when I was 16. I lied about my age to get into nursing school at age 17. I was going
to be a teacher; passed a teacher’s examination but couldn’t afford to buy a car to
drive myself back and forth to school. My sister Luta was already in nursing school
at the Florida State Hospital, so I applied to nursing school there, too. I attended
nursing school from 1932-1935 and graduated with my nursing class of five in 1935.
I was the highest scorer on the board exams from my class and received a trophy for
highest achievement. My sister had also graduated at the top of her nursing class.
Q, How did you meet Dr. Rogers?
A. He was a doctor at the FSH and was one of my instructors. I met back up with
him a few years later when working in Tallahassee or when working in Jacksonville
as a nurse [she couldn’t remember exactly]. He was a very good teacher and I
learned a lot from him but never dated Dr. Rogers at all while a student at the
hospital.
Q. What did you think of Chattahoochee? Where did you live when you first
arrived?
A. I liked it but didn’t know many people outside of the hospital. As a student
nurse, I lived just across the street from the main hospital (in Landis Hall) in a
dormitory for all the student nurses, and maybe some off-duty employees. Life was
Out of Mind, Out of Sight
217
different for us then. The laundry operated on site and we sent out our uniforms for
cleaning. The nursing students and nurses always wore their uniforms for work,
unlike today when some nurses wear street clothes. Back then there was also medical
care available for all the nurses right there on grounds of the hospital.
Q. What was nursing school like?
A. We treated doctors with total respect, and learned a lot from them. If the
doctor walked in the room, the nurses would all stand up. The nursing program had
very strict rules and some of the other girls in the program would come to my room
to sneak out, because I had a corner room on the bottom floor. But I never did such a
thing myself! We could date in school, but if we got married, we were out of the
program. [Her class started out with 15 or 20 girls, but only five of them graduated.]
Q. What did you do after you graduated nursing school?
A. I had a job working for a doctor in Thomasville for a short while, then
worked for a doctor in Tallahassee. My older sister (Luta) had been working for a
doctor in Marianna, and he taught her about anesthesia. Luta wanted to get further
advanced in that field, so she talked me into going to Philadelphia and taking an
anesthesia course. We were up there for about nine months and when the term was
up, Luta had a job at the Florida State Hospital. After that course, I got a job with St.
Vincent’s Hospital in Jacksonville, and that’s when my romance with Dr. Rogers
started up again. We got married in 1937 and moved right onto the grounds of the
hospital; I never worked professionally again.
Q. Tell me about the house(s) where you lived on the grounds of the Florida
State Hospital. Am I correct that you lived in what is now the administration
building from 1950-1961?
A. There were some houses for medical doctors and we lived in one of those
two-stories for a while. We moved into the superintendent’s house (the
administration building) in 1950 and lived there until 1961. Dr. Rogers had the idea
to move into the superintendent’s house because he felt he deserved it since he had
moved up in authority.
Sally J. Ling
218
Our bedroom was in the upstairs of the superintendent’s house. My mother
and our kids lived on the downstairs of the house. My mother had a stroke and
Rogers put her in the hospital here. Then she moved downstairs and we put a buzzer
in and she stayed there in that house with us until she died. The rooms in that house
today are pretty much as they were when we lived there.
The building was not air conditioned at first. The first room to be air-
conditioned was our bedroom. We were the last family to live in the
superintendent’s house before it was converted entirely into administration offices.
Both of our boys were born while we lived in that house: William, Jr. in 1944 and
John in 1947. I drove them to school every day and they would fight about who got
to sit in the front every day. They went right through high school here in
Chattahoochee. The boys were big sports players, mostly basketball. I’m a big sports
enthusiast and enjoy football, basketball, baseball, and playing golf.
There was a rumor that there was a big tunnel underneath the
superintendent’s house, and I remember that every time a kid came to play with my
boys they would try to find the big tunnel under the house, but they never found it.
That house also shared space with business offices, so Dr. Rogers office
was literally right next to the residence portion of the house, and he came home for
lunch most days. The house and the offices shared a porch.
In 1961, we moved out of the superintendent’s house into a new house we
had built on the hospital grounds. Towards the ‘70s, Dr. Rogers started thinking
about where we were going to live once he retired, so he built my home here,
modeled exactly on the home we lived in after the superintendent’s home on the
hospital grounds.
I didn’t miss living on the grounds after we moved to our private residence
when Dr. Rogers retired. When we moved to the new house, we still kept our help
[paid by the State] until Dr. Rogers retired in 1974.
Q. What was the hospital like when you first arrived?
A. We were assigned different areas of the hospital to work when we were in
nursing school with graduate supervisors who were in charge of the students who
were doing the care of the patients. I dealt with mostly older patients, long-term [not
necessarily mentally ill patients].
Out of Mind, Out of Sight
219
When I was working there, there was only one main hospital the majority
of the sick patients were there. Ms. Kirkland was in charge of most of the white
female patients who were not medically sick.
Most of the buildings were heated with steam pipes underground. William
Jr. came home one day saying his feet were hot and it turned out it was because he
had been walking in those steam tunnels. I forbid him from ever going back into
them. In the old days, they would carry people out of the medical building into the
morgue or the TB ward using those tunnels, when it was too cold or for some other
reason they didn’t want to go outside.
Q. Did you have much contact with patients throughout your time there (i.e.,
any working for you? Around the house? Around the grounds?)
A. Not really. I had a cook and a housekeeper employed by the State. Other
employees that lived on the grounds had patients working in their homes, but I never
did. The only time I really ever saw patients was if one accidentally wandered into
the house instead of the business end of the building. [The business offices were
housed in the same building as their home while they lived in the superintendent’s
house.]
I wasn’t afraid of them but never had too much contact with them. [She
does have some things that were made by patientssome lovely pale blue dishes
with white ornamentation on them that were made at the occupational therapy
department, under the supervision of Mary Harvard. Mrs. Rogers loves the dishes,
but they spelled her name wrong on the underside (Rodgers). They were a Christmas
gift, and are dated 12/25/54.]
The occupational therapy department was for patients who were
mentally capable of accepting that work. They made our dining room chair covers
[embroidered silk]. I also have a table that an employee built us - Jaybird Freeman
[deceased]. Other furniture in the superintendent’s house on the grounds [two twin
beds, and some other furniture, and dishes] was also made at the hospital.
We had fresh milk and veggies delivered every day from the garden. I
could go to the kitchen that cooked for the dining hall and get a chicken or whatever
we needed. Staff left food for us on a daily basis in a big cattycornered room off the
house that had an ice chest. The iceman came every day.
Sally J. Ling
220
Q. What was Dr. Roger’s job like? Did he work long hours?
A. In the early days, he was always home at night. Then when he became state
administrator, he was gone some, but it wasn’t too different for me. I always had
help in the kitchen and around the house [cook and housekeeper] and I had the boys,
so it was never any trouble or lonely when he was gone for work.
Q. What were his biggest concerns?
A. Patient concerns were his life’s work and that was definitely his biggest
concern. He would take trips all over the state, once he became the Division of
Mental Health director, to look in on and work with the other hospitals that housed
mental patients.
Q. What did Dr. Rogers used to wear?
A. White men’s jackets, just like today. I sent his jackets to the hospital
laundry. He also wore white linen suits. Patients worked at the laundry but they had
a supervisor. We could send our clothes and bed linens to the laundry but I did some
of my own laundry.
Q. Did you entertain a lot?
A. We didn’t entertain a lot, but when I did I always had help to fix the meals.
Ida O’Connor was my next-door neighbor and we were close. Dr. O’Connor was the
clinical director. After Dr. Rogers went to Tallahassee for his director job, Dr.
O’Connor was the superintendent at FSH. My friend Eleanor’s husband was a
purchasing director for the state and Eleanor and I played golf together.
The hospital had a golf course. Several friends and I decided to get a group
of golfing women together after all the men took off for their golf games every
Sunday. For a while, we went over to Quincy and took lessons from a pro. I played
once a week or more if anyone was ready to play, particularly after the boys got big
enough to go to school. After Emily Hart came, she played a little, but there weren’t
a lot of women players. My golfing buddies didn’t necessarily all live on the
grounds. Jean didn’t live on the grounds all the time but that was when we played
at the [Seminole Valley] country club.
Out of Mind, Out of Sight
221
We used to have Easter egg hunts all along the lawn of the administration
building. They were for the whole community. Also, the Harry Shepherd orchestra
played at the hospital’s weekly dance [Harry Shepherd was head of finance for the
hospital]. There was also a weekly dance for patients. Sometimes the doctors would
go.
The interview ended as Mrs. Rogers was tired and needed to rest.
Sally J. Ling
222
Out of Mind, Out of Sight
223
At the time of researching and writing this book, the referenced websites were active.
While the author makes every effort to be as accurate as possible, websites change and
evolve over time. Because of this, the author cannot vouch for the accuracy of the websites
at time of publication.
1
Dale Cox, The Early History of Gadsden County, Florida, 2008, p. 91
2
Ibid, 89-90.
3
Richard W. Scott to Edmund P. Gaines, November 28, 1817, American State
Papers,
Military Affairs, Volume 1, p. 688.
4
Cox, p. 91-94.
5
Seminole Tribe of Florida, History “Introduction,”
http://www.semtribe.com/History/Introduction.aspx.
6
Cox, p. 94.
7
Ibid.
8
General Gaines to John C. Calhoun, December 4, 1817, ASP, Military Affairs, Volume 1,
p. 688.
9
Ibid.
10
Turnage, Grady, “From Mount Vernon to Chattahoochee,”19??, p. 3.
11
John C. Calhoun to Andrew Jackson, December 26, 1817, ASP,
Military Affairs, Volume 1, p. 690.
12
Seminole Indian Tribe of Florida, History, “Indian Resistance and Removal.”
http://www.seminoletribe.com/history/IndianRemoval.aspx. (1/5/2013)
13
Turnage, p. 8.
14
“Indian Removal Act,” Twenty First Congress, Sess. I. Ch. 148. 1830, Chap. CXLVIII, pp.
411-412.
15
Cox, p. 157.
16
Ibid, p.158.
17
Turnage, pp. 4, 8, 32.
18
Ibid, pp. 4-6.
19
Boyd, Mark F., “The Apalachicola or Chattahoochee Arsenal of the United States,” 1958,
p. 35, M93-4, Box 4, Tallahassee Historical Society Records.
20
Ibid.
21
Anonymous, “Two Days in Chattahoochee,” Tallahassee Floridian, December 5, 1935,
p.3.
ENDNOTES
Sally J. Ling
224
22
Turnage, p. 6.
23
Boyd, p. 36.
24
Cox, p. 162.
25
US History, “Second Seminole War,” http://www.u-s-history.com/pages/h1139.html.
(1/5/2013)
26
Cox, p. 163.
27
Apalachicola Gazette, quoted in the Vermont Phoenix, June 21, 1839,
p. 3.
28
Turnage, p. 10.
29
Yulee, C. Wicliffe, “Senator David L. Yulee,” Florida Historical Quarterly, 1909, Vol. 2,
No.2, p. 13-14. 1909.
30
Cox, pp. 201-204.
31
Boyd, p. 40.
32
Boyd, p. 40, 41.
33
Freedman’s Bureau Online, http://freedmensbureau.com. (1/5/2013)
34
Boyd, p. 41.
35
Fryman, Mildred L., “Career of a ‘Carpetbagger’ Malachi Martin in Florida”, The Florida
Historical Quarterly, Vol. 56, No. 3, Jan 1978, p. 322.
36
Ibid.
37
Turnage, p. 12.
38
“Report of M. Martin,” Florida Senate Journal, 1970, Appendix, p. 93.
39
Florida House Journal, 1873, Warden’s Report, pp. 135-136A.
40
Ibid.
41
Fryman, Mildred L., “Career of a ‘Carpetbagger’: Malachi Martin in Florida,” Florida
Historical Quarterly, Vol. 56, No. 3 (Jan., 1978), p. 319.
42
Ibid.
43
Florida State Penitentiary Record Book 1868-?. ( lost or destroyed)
44
Powell, J.C., The American Siberia Or Fourteen Years' Experience In a Southern Convict
Camp, p. 8.
45
Ibid, p. 17.
46
Florida Corrections: Centuries of Progress, ttp://www.dc.state.fl.us/oth/timeline/1868-
1876.html, 1868-1876.
47
Martin, Malichi, Annual Report of the Adjutant General of the State of Florida for Year
Ending December 31, 1874, p. 130.
48
Reports of the Adjunct General and Warden State Prison Years 1869-1888, p. 144.
49
Ibid, pp. 144-145.
50
Ibid, p. 131.
51
Reports of the Adjunct General and Warden State Prison Years 1875-1876, State Journal
1877, p. 162.
52
Tingley, Charles, email to Sally J. Ling, 2010.
53
Find a Grave, Betsy Yulee, http://www.findagrave.com/cgi-
bin/fg.cgi?page=gr&GSln=yulee&GSfn=betsy&GSiman=1&GScid=2225761&GRid=23083
088&. (1/5/2013)
54
Fryman, p. 329.
55
Ibid, p. 331.
56
Ibid, p. 333.
Out of Mind, Out of Sight
225
57
Turnage, p. 12.
58
Kline, R. & Puerzer, Ellen, West Gadsden County Historical Society,
http://www.octagon.bobanna.com/FL.html. (1/5/2013)
59
Biennial Report of the State Prison, Commencing March 4th, 1877, and Ending December
1st, 1878, p. 6.
60
Powell, p.7.
61
Ibid, pp.8, 10.
62
Martin, M., Reports of Adjutant General and Warden State prison Years 1969-1888, p. 92.
63
Powell, p. 8.
64
Ibid, p. 9.
65
Ibid, p. 15.
66
Ibid, pp. 9-10.
67
Ibid, pp. 50-51.
68
Ibid, p. 9.
69
Dr. Hankins, J.S., “Report of Surgeon of Convict Camps,” Senate Journal 1879, p. 241.
In 1913, an 18,000-acre tract of land near Ocala known as "Marion Farms" was purchased
“as the location for a new central prison hospital for aging, crippled and infirm inmates,”
prisoners who could not be leased to private businesses. It was named Raiford State
Penitentiary and was also referred to as the "State Prison Farm," "Raiford Prison" and
"Florida State Prison." Ten years later, Governor Cary Hardee discontinued the convict lease
system and all state prisoners were transferred to Raiford.
http://www.dc.state.fl.us/oth/timeline/1900-1919, and 1922-1924.html.
70
Gerald N. Grob, The Mad Among US, A History of the Care of America’s Mentally Ill,
Harvard University Press, Cambridge, Massachusetts, London, England, 1994, p. 10.
71
Ibid, p. 11.
72
Ibid, p. 5.
73
Merriam-Webster Dictionary, http://www.merriam-webster.com/dictionary/lunatic.
(1/5/2013)
74
Grob, p. 6.
75
Kristen A. Graham, A History of the Pennsylvania Hospital, The History Press, 2008, p.
40.
76
Ibid, p. 18.
77
Ibid, p. 20.
78
Ibid, p. 21.
79
Ibid, p. 39.
80
Soreff, Dr. Stephen M. and Bazemore, Dr. Patricia H., “Confronting Chaos,” Behavioral
Healthcare, June 2006, p. 18.
81
Medieval Medicine, The Humors; http://www.intermaggie.com/med/humors.php.
82
Personalities, theories, types and tests, The Four Temperaments, The Four Humors,
http://www.businessballs.com/personalitystylesmodels.htm#four temperaments four
humours. (1/5/2013)
83
Benjamin Rush, http://www.ushistory.org/declaration/signers/rush.htm. (1/5/2013)
84
Bloodletting and the Four Humors;
http://www.collectmedicalantiques.com/bloodletting.html. (1/5/2013)
85
Soreff, pp. 16-17.
Sally J. Ling
226
86
Ibid, p. 17.
87
Ibid.
88
Graham, Kristen A., A History of the Pennsylvania Hospital, pp. 40, 42.
89
Soreff, p. 17.
90
Hydrotherapy, Alternative Medicine,
http://altmedicine.about.com/od/therapiesfrometol/a/hydrotherapy.htm (1/5/2013)
91
Hicks, David W. and Opsahl, Stephen P, “The Warm Springs of the Southwest Georgia
Piedmont,” http://www.sherpaguides.com/georgia/flint_river/sidebars/warm_springs.html.
(1/5/2013)
92
Harmon, Rebecca Bouterie, PhD, “Hydrotherapy in State Mental Hospitals in the Mid-
Twentieth Century,” Issues in Mental Health Nursing, 2009, 30:491.
93
Ibid.
94
Hubbard, L.D., MD, “Hydrotherapy in the Mental Hospital,” The American Journal of
Nursing, Vol. 27, No. 8, Aug. 1927, pp. 642.
95
Harmon, p. 492; Hubbard, p. 642.
96
Ibid.
97
Harmon, p. 493.
98
Hubbard, p. 643.
99
Soreff, p. 17; Hubbard, p. 643.
100
Soreff, p. 18, Hubbard, p. 644.
101
Hubbard, pp. 642-643.
102
Ibid, p. 644.
103
James W. Trent, Jr., “Moral Treatment,” Disability History Museum,
http://www.disabilitymuseum.org/dhm/edu/essay.html?id=19 (1/5/2013)
104
Grob, p. 20.
105
Graham, pp. 39-40.
106
Ibid, p. 42.
107
James W. Trent, Jr., “Moral Treatment,” Disability History Museum,
http://www.disabilitymuseum.org/dhm/edu/essay.html?id=19 (1/5/2013)
108
Grob, p. 55.
109
Geller, Jeffrey L., and Harris, Maxine, Women of the Asylum, Anchor Books, 1994, p. 34.
110
Ibid, p. 35.
111
Ibid, p. 39.
112
Florida Health Notes, Vol. LII, No. 10 (Jacksonville: published by the Board of Health,
1960), p. 193.
113
State of Florida, Acts of the Legislative Council, 1832, p. 110.
114
Weiser, 53; Richard Chardkoff, “Development of State Responsibility for the Care of the
Insane in Florida, 1830-1850” (MA Thesis, 1964), 3.
115
Florida Senate Journal, 1850, Attorney General’s Report in the Appendix, p. 10.
116
Florida Senate Journal, 1852, pp. 137, 195.
117
Acts and Resolutions, 1852, p. 157.
118
Florida Senate Journal, 1854, pp. 304-306.
119
Ibid, p. 316
120
Florida House Journal, 1855, pp. 23-24.
121
Florida Senate Journal, 1855, p. 124.
Out of Mind, Out of Sight
227
122
“General Presentment of the Grand Jury of Leon County for the Fall Term of 1856,The
Floridian and Journal, Nov. 1, 1856, Vol. VIII, No. 44.
123
The Floridian and Journal, Tallahassee, Florida, Dec. 13, 1856, Vol. VIII, No. 50.
124
Laws of Florida, 1856, Ch. 792, Sec. 26.
125
Ibid.
126
Florida House Journal, 1858, pp. 24-25.
127
Acts and Resolutions, 1858, p. 135.
128
Reports of Comptroller Treasurer and Trustees of Internal Improvement Fund, 1874,
(Tallahassee: Dyke and Carlisle, 1874), p. 116.
129
Florida Senate Journal, 1874. Report of Comptroller in the Appendix.
130
Eighth Census:1860, p. 98.
131
Report of the Comptroller, 1878, pp .9-10A.
132
Laws of Florida 1877, Ch. 3035, Sec. 95.
133
Senate Journal, 1879. Tallahassee, Fl: C.E. Dyke, Sr., State Printer.
134
Senate Journal, Tallahassee, Florida, 1879, p. 234.
135
Ibid, p. 236.
136
Chardkoff, Rickard B., “The Development of State Responsibility for the Care of the
Insane in Florida, 1830-1950,” Thesis, April 1964, p. 43.
137
Ibid.
138
Ibid.
139
Report of the Adjutant General of the State of Florida, 1877-1878, pp. 9-10.
140
Senate Journal, Tallahassee, Florida, 1879, pp. 239-240.
141
Nelson, Dave, “More of a Prison than an Asylum: Florida Hospital for the Indigent Insane
during the Progressive Era,” School of Social Sciences, V. XVI 2009, No. 3 & 4, Fall/Winter
2009, p. 8.
142
Geller/Harris, p. 110.
143
Ibid, p. 83.
144
Ibid, 139.
145
Ibid, 163.
146
Ibid, pp. 164,165 (Charlotte Perkins Gilman).
147
Ibid, p. 126 (Ada Metcalf).
148
Senate Journal, Tallahassee, Florida, 1879, p. 239.
149
Geller, Harris, pp.112-113
150
Messages and Documents, 1893; Report of Superintendent of State Insane Asylum, p.5.
151
Fleming, E.B, and Fleming, Agustin, Three Years in a Mad House, Donohue, Hennebery
& Company, 1893, p. 21, John, P. McGovern Historical Collections and Research Center,
http://mcgovern.library.tmc.edu/data/www/html/texascoll/Psych/TYM/TYMContents.htm.
(1/5/2013)
152
From the Governor’s Message, House Journal, 1879, Tallahassee, FL: C. E. Dyke, Sr.,
State Printer, pp. 32-33; Division of Historical Resources, Drew Mansion.
153
Journal of the Proceedings of the Assembly of the State of Florida, 1881, (Tallahassee:
Charms A. Finley, State Printer, 1881), pp. 252-253.
154
Florida House Journal, 1887, Report of Superintendent of the Asylum, p. 40.
155
Grob, p. 117.
156
Report of the Superintendent of the Florida Insane Asylum, for the period Beginning
January 1, 1891 and Ending December 31, 1892, p. 5.
Sally J. Ling
228
157
Report of the Superintendent of the Florida Insane Asylum, for the period Beginning
January 1, 1890 and Ending December 31, 1890, pp. 3-4.
158
Ibid, p. 5.
159
Perugi G, Akiskal HS, Rossi L, Paiano A, Quilici C, Madaro D, et al. Chronic mania.
Family history, prior course, clinical picture and social consequences. Br J Psychiatry
1998;173:5148.
160
Report of the Superintendent of the Florida Insane Asylum, for the period Beginning
January 1, 1891 and Ending December 31, 1892, p. 9.
161
Trammell to David Lang, 11 February 1896, Florida Hospital for the Insane
administrative files, 1885-1914, Box 1, folder: “Patients, 1885-1897,” FSA.
162
Find a Grave: Florida State Hospital, http://www.findagrave.com/cgi-
bin/fg.cgi?page=cr&CRid=2225761. (1/5/2013)
163
“Florida State Hospital cemetery: efficient, anonymous,” St. Petersburg Times, August
16, 1976, 8B.
164
Analysis of new arrivals in 1901, Biennial Report of the Superintendent of the Florida
Hospital for the Insane, 1901-1902, p. 33.
165
Messages and Documents, pp. 23-24; Superintendent’s Report 1897, pp. 16-22.
166
Lang to Mr. J.N. Bradsh, Clerk of Board of County Commissioners, Orange County, 3
August 1896, Commitment Records, 1893-1973, Letter Book Volume 3, 1894-1897, FSA.
167
Ibid.
168
Lang to Hon. James Hill, Marion County, 10 August 1896, Commitment Records, 1893-
1973, Letter Book Volume 3, 1894-1897, FSA.
169
Messages and Documents, 1894, p. 5.
170
Cutler, H.G., History of Florida (Chicago: Lewis Publishing Co, 1923), Vol. I. p. 255.
171
Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1901-1902,
pp. 13-15.
172
Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1905-1906,
p. 11.
173
House Journal, 1905, pp. 1164-1165.
174
“Florida State News,” The Weekly True Democrat, May 26, 1905, p. 5.
175
House Journal, 1905, p. 2142.
176
Ibid, p. 1204.
177
Ibid, p. 2195
178
Ibid, p. 1204.
179
Ibid, p. 1204-1205.
180
Ibid, pp. 2132-2135.
181
Ibid, p. 1167.
182
Ibid, p. 1166.
183
Ibid, p. 1164.
184
“The Insane Hospital: State Press Opinions on the Investigating Committee’s Report,”
The Weekly True Democrat, June 2, 1905, p. 7.
185
“House Adopts Hospital Report,” The Weekly True Democrat, May 26, 1905, p. 1.
186
“What the State Newspapers Say,” The Weekly True Democrat, June 9, 1905, p. 1.
187
Ibid.
188
Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1905-1906,
pp. 16, 19.
Out of Mind, Out of Sight
229
189
Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1907-1908,
pp. 1-31
190
Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1909-1910,
pp. 7, 9.
191
While the use of cribs was eliminated in previous administrations, they were brought back
in subsequent administrations.
192
Superintendent’s Report, 1913, pp. 19-20.
193
Ibid, 1913-1914, p. 30.
194
Ibid, 1913, p. 17.
195
Biennial Report of the Superintendent of the Florida Hospital for the Insane, 1913-1914,
pp. 1.
196
Superintendent’s Report, 1917-1918, p. 9.
197
Biennial Report of the Superintendent of the Florida Hospital for the Insane for the Years
1914-1916 (Tallahassee: T.J. Appleyard, State Printer).
198
H.G. Cutler, History of Florida (Chicago: Lewis Publishing Co., 1923), Vol. I, p.256.
199
Biennial Report of the Superintendent of the Florida Hospital for the Insane for the Years
1921-1922, p. 39.
200
Biennial Report of the Superintendent of the Florida Hospital for the Insane for the Years
1919-1920, p. 256. Physician’s Report, 1919, pp. 32-33.
201
Superintendent’s Report, 1919-1920, pp. 256-257. Physician’s Report, 1919, pp. 20-21.
202
Physician’s Report, 1923-1924, pp. 34-35. Physicians Report, 1925-1926, p. 34.
203
Physician’s Report, 1925-1926, pp. 12-18.
204
Superintendent’s Report, 1928-1930, pp. 7, 8, 11.
205
Series 1063, Carton 85, File Folder 1, Florida State Archives.
206
Series 1063, Carton 85, Folder 99, Florida State Archives.
207
Mendoza, Rebekah, via emails 2010.
208
Superintendent’s Report, 1932-1934, p. 8.
209
Superintendent’s Report, 1934-1936, pp. 11-17.
210
Ibid, pp. 31-32.
211
Page: 84
Ibid, pp. 36-39.
212
Florida State Hospital Chattahoochee, Biennial Report for the Period 1934-1936, p. 56.
213
Ibid, p. 45.
214
While extensive research was done to try to find additional information on the wild life
preserve, no state or county records were found.
215
Laws of Florida, 1935, Ch. 2, Sec. 104.
216
Superintendent’s Report, 1934-1936, p. 83.
217
Ibid, pp. 10, 59-60.
218
Ibid, pp. 87.
219
Ibid, pp. 18-19.
220
Ibid, p. 46.
221
Ibid, p. 48.
222
Ibid, p. 109.
223
Farnahan, MD, Report of Inspection and Survey of Florida State Hospital Chattahoochee,
p. 1.; http://freepages.genealogy.rootsweb.ancestry.com/~chattahoochee/Farnhan.htm
Sally J. Ling
230
224
Letter from C.M. Wiggins to Board of Commissioners of State Institutions, April 29,
1938, Box from 1938, Record Group 841, Series 1063, FSA.
225
Information Blank for Florida State Hospital, Percy A. Graham, May 2, 1938 Box from
1938, Record Group 841, Series 1063, FSA.
226
Admittance form, May 4, 1938,Box from 1938, Record Group 841, Series 1063, FSA .
227
Letter from Mrs. Lean Graham to Ralph E. Stephens, M.D., The Florida State Hospital,
July 24, 1938, Box from 1938, Record Group 841, Series 1063, FSA.
228
Notes of Staff Conference, August 8, 1938, Box from 1938, Record Group 841, Series
1063, FSA.
229
Letter from Ralph E. Stevens, MD to Mrs. Lena P. Graham, August 18, 1938, Box from
1938, Record Group 841, Series 1063, FSA.
230
Western Union telegram from the Florida State Hospital to Lena Graham, October 22,
1938, Box from 1938, Record Group 841, Series 1063, FSA.
231
Letter from Ralph E. Stevens, MD to Mrs. Lena Pl Graham, October 22, 1938, Box from
1938, Record Group 841, Series 1063, FSA.
232
Report of Inspection of Body and Undertaking of Deceased Patient Prepared for Burial or
for Shipment, Box from 1938, Record Group 841, Series 1063, FSA.
233
Grob, p. 178.
234
Ibid, p. 180.
235
Ibid, pp. 180-181.
236
Ibid, p. 181.
237
Huskey, Dr. A.L., “Insulin Shock Therapy at Florida State Hospital,” Journal of the
Florida Medical Association, Vol. XXV, No. 6, November 1938, p. 231.
238
Ibid, p. 232.
239
Sabitini, Renato M.E PhD, “The History of Shock Therapy in Psychiatry,”
http://www.cerebromente.org.br/n04/historia/shock_i.htm#meduna. (1/5/2013)
240
Huskey, pp. 232-233.
241
Sabitini, Renato M.E PhD, “The History of Shock Therapy in Psychiatry,”
http://www.cerebromente.org.br/n04/historia/shock_i.htm#meduna. (1/5/2013)
242
Ibid.
243
Grob, p. 185.
244
“Use of Electroconvulsive Treatment for Residents of State Mental Health Treatment
Facilities,” State of Florida Department of Children and Families Tallahassee, August 1,
2008, CFOP 155-40.
245
Grob, p. 182-183.
246
http://science,jrank.org/pages/5576/Psychosurgery-History.html
247
Manjila, S., Rengachary, S., Xavier, A., Parker, B., and Guthikonda, M. “Modern
Psychosurgery before Egas Moniz: a tribute to Gottlieb Burckhardt.” Journal of
Neurosurgery, July 2008 Volume 25, Number 1-
http://thejns.org/doi/full/10.3171/FOC/2008/25/7/E9.
248
Manjila S, Rengachary S, Xavier AR, Parker B, Guthikonda M. “Modern psychosurgery
before Egas Moniz: a tribute to Gottlieb Burckhardt,” Neurosurgical Focus 2008; 25(1):E9.
249
Jansson, Bengt. “Controversial Psychosurgery Resulted in a Nobel Prize.” Oct. 29, 1998.
http://nobelprize.org/nobel_prizes/medicine/articles/moniz
250
Freeman, III, Walter (Son of Walter Freeman), “The Lobotomist.” American Experience,
PBS.
Out of Mind, Out of Sight
231
251
“The Lobotomist.” American Experience, PBS.
252
Sullivan, Edward, M.D., personal interview.
253
“The Lobotomist.” American Experience, PBS.
254
Ibid. Edward Shorter, Medical Historian.
255
Weil, Martin. “Rosemary Kennedy, 86; President's Disabled Sister,” Washington Post,
January 9, 2005, p. B06.
256
Kessler, Ronald, “Rosemary Kennedy’s Inconvenient Illness,” Newsmax.com, Tuesday,
June 17, 2008.
257
Weil, p. B06.
258
Kessler, Ronald, “Rosemary Kennedy’s Inconvenient Illness,” Newsmax.com, Tuesday,
June 17, 2008, http://www.newsmax.com/RonaldKessler/Rosemary-
Kennedy/2008/06/17/id/324146. (1/5/2013)
259
Ibid.
260
Ibid.
261
“History of Neurosurgery and Neurology in Jacksonville,” James G. Lyerly, Jr., M.D., pg.
1.
262
Sullivan, Dr. Edward, personal interview 2009.
263
Ibid.
264
Lyerly, James G., Sr., “Transsection of the Deep Association Fibers of Prefrontal Lobes
in Certain Mental Disorders,” The Southern Surgeon, Vol. 9, 1939, p. 431.
265
Ibid, p. 432.
266
Lyerly, M.D., James G. “Results of Lobotomy in Mental Disorders,” Southern Medical
Journal, Sept. 1952, pp. 798.
267
Lyerly, J.G, M.D., “Prefrontal Lobotomy in Involutional Melancholia,” The Journal of
the Florida Medical Association, Vol. XXV, Number 5, p. 226.
268
Lyerly, James G., “Transsection of the Deep Association Fibers of Prefrontal Lobes in
Certain Mental Disorders,” The Southern Surgeon, Vol. 9, 1939, p. 432.
269
Ibid, p. 427, 428.
270
Lyerly, M.D., James G. “Results of Lobotomy in Mental Disorders,” Southern Medical
Journal, Sept. 1952, pp. 795.
271
Lyerly, James G., “Transsection of the Deep Association Fibers of Prefrontal Lobes in
Certain Mental Disorders,” The Southern Surgeon, Vol. 9, 1939, p. 433.
272
Ibid.
273
Ibid, p. 433-434.
274
Ibid.
275
Lyerly, M.D., James G. “Results of Lobotomy in Mental Disorders,” Southern Medical
Journal, Sept. 1952, pp. 795-796.
276
“History of Neurosurgery and Neurology in Jacksonville,” James G. Lyerly, Jr., M.D., pg.
1.
277
Sullivan, Dr. Edward, personal interview, 2010.
278
Ibid.
279
Ibid.
280
Lyerly, Dr. James G., Jr., personal interview 2009.
281
Lyerly, James G., “Transsection of the Deep Association Fibers of Prefrontal Lobes in
Certain Mental Disorders,” The Southern Surgeon, Vol. 9, 1939, p. 511.
Sally J. Ling
232
282
Forrester, Angelene, daughter of patient. “The Lobotomist.” American Experience, PBS.
Program transcript, p. 1.
283
“The Lobotomist.” American Experience, PBS, Program Transcript.
284
Ibid..
285
El-Hai, Jack, “The Lobotmist,” The Washington Post Magazine, February 4, 2001.
286
“Remembering the Tragedy of Lobotomies,” Psychosurgery,
http://www.psychosurgery.org/about-lobotomy/ (2010)
287
Swayze II, Victor W., M.D., Frontal Leukotomy and Related Psychosurgical procedures
in the Era Before Antipsychotics (1935-1954): A Historical Overview,” American Journal of
Psychiatry, 152:4, April 1995, p. 511.
288
Ibid, p. 509-510.
289
El-Hai, Jack, “The Lobotmist,” The Washington Post Magazine, February 4, 2001.
290
“The Lobotomist.” American Experience, PBS, Program Transcript.
291
Ibid.
292
Lyerly, M.D., James G., “Results of Lobotomy in Mental Disorders,” Southern Medical
Journal, Sept. 1952, Vol. 45, No.9, p. 795.
293
Ibid, p.794.
294
Sullivan, personal interview, 2010.
295
Lyerly, Dr. James G., Jr., personal interview, 2010.
296
Florida State Hospital Biennial Reports, RB 841, Series 1071, 1940-1942, p. 18.
297
Ibid, p. 21.
298
Ibid, p. 191 and 195.
299
Ibid, p. 203-204.
300
Ibid, p. 206.
301
Walls, Theresa, "The National Mental Health Act of 1946 and the Establishment of
NIMH: Ongoing Challenges," Scattergood Ethics,
http://www.zoominfo.com/CachedPage/?archive_id=0&page_id=-
1670095225&page_url=//www.scattergoodethics.org/?q=node/1146&page_last_updated=20
11-01-14T17:23:49&firstName=Theresa&lastName=Walls. (1/5/2013)
302
Drug rehab wiki, National Institute of Mental Health,
http://www.drugrehabwiki.com/wiki/National_Institute_of_Mental_Health. (1/5/2013)
303
Florida State Hospital Biennial Report, 1938-1940, pp. 5-6.
304
Ibid, pp. 13, 24.
305
Ibid, p. 13.
306
Ibid, p. 31.
307
Florida State Hospital Biennial Report, 1938-1940, p. 44.
308
Florida State Hospital Biennial Report, 1946-1948, p. 36.
309
Ibid, p. 44.
310
Florida State Hospital Biennial Report, 1938-1940, p. 40.
311
Florida State Hospital Biennial Reports, 1948-1950, p. 31.
312
Florida State Hospital Biennial Report, 1938-1940, p. 40.
313
Florida State Hospital Biennial Reports, 1940-1948.
314
Cunningham, Sam, Clinical Psychologist 1950-1988, personal interview 2009.
315
Florida State Hospital Biennial Reports, 1942-1944, p. 51.
316
Florida State Hospital Biennial Report, 1938-1940, p. 54.
Out of Mind, Out of Sight
233
317
Jones, Norman “Champ,” Utilities and Maintenance Supervisor 1973-1993, personal
interview 2010.
318
Bergal, Jenni, “Golf Might be Good for One’s Mental Health, but HRS Goes Too Far,”
Sun Sentinel, July 26, 1993, 7A.
319
Ibid.
320
Baraneau, Jim, personal interview 2010.
321
Bergal, Jenni, “Golf Might be Good for One’s Mental Health, but HRS Goes Too Far,”
Sun Sentinel, July 26, 1993, 7A.
322
Ibid.
323
Baraneau, Jim, personal interview 2010.
324
Bergal, Jenni, “Golf Might be Good for One’s Mental Health, but HRS Goes Too Far,”
Sun Sentinel, July 26, 1993, 7A.
325
Florida State Hospital Biennial Report, 1946-1948, p. 77.
326
Freeman, Paul, “Abandoned and Little Known Airfields,”
http://members.tripod.com/airfields_freeman/FL/Airfields_FL_FtMyers.htm#dorr.
(1/5/2013)
327
“Aviation and Southwest Florida - History Of Florida Aviation,”
http://sites.google.com/site/donbrowne/aviation. (1/5/2013)
328
Florida State Hospital Biennial Reports (1948-1950), RG 841 Series 1071, p. 80-81.
329
Fifteenth Census of the United States, 1930.
330
Florida State Board of Health Bureau of Vital Statistics, State File No. 6656.
331
Admittance Record, Florida State Hospital, DCF.
332
Florida State Hospital Records, Master Patient Index.
333
Annis, Dr. Larry, personal interview, 2009.
334
Isobel Castiglioni Gately, personal interview, March 2010.
335
Admittance Record, Florida State Hospital, May 4, 1938.
336
White, Viki, (granddaughter of Spartaco and Teresa Castiglioni), personal interview,
March 2010
337
Florida Department of Vital Statistics, Death Notices, Gloria Castiglioni.
338
Florida State Hospital Biennial Reports (1952-1954), RG 841 Series 1071, p. 9, 57-67.
339
Krueger, Curtis, “State mental hospital shuts down,” St. Petersburg Times, February 9,
2002.
340
CRIPA Investigation, Memorandum, March 23, 1995;
http://www.clearinghouse.net/chDocs/public/MR-FL-0001-0001.pdf.
341
Ibid.
342
Krueger, Curtis, “State mental hospital shuts down,” St. Petersburg Times, February 9,
2002.
343
Florida State Hospital Biennial Reports 1950-1952, RB 841, Series 1071, p. 9.
344
Ibid, p. 23.
345
House Journal, 1951, p. 1200.
346
Ibid, p. 1198.
347
Ibid, p. 1198-1199.
348
Florida State Hospital Biennial Reports 1950-1952, RB 841, Series 1071, p. 24.
349
Florida State Hospital Biennial Reports 1952-1954, RB 841, Series 1071, p. 30.
Sally J. Ling
234
350
Journal of Nervous and Mental Disease, “The Tomkins Horn Picture Arrangement Test,”
http://journals.lww.com/jonmd/Citation/1958/01000/The_Tomkins_Horn_Picture_Arrangem
ent_Test.16.aspx.
351
Letter from Jackie Humes to Sally J. Ling, Dec. 9, 2010.
352
Commitment Records, S1062, Carton 183, Box description: B 4/1959-9/1959; 9/1959-
6/1960, Florida State Archives.
353
Ibid.
354
Ibid.
355
Ibid.
356
Ibid.
357
Grob, p. 226
358
Ibid, p. 228.
359
“People and Discoveries,” PBS,
http://www.pbs.org/wgbh/aso/databank/entries/dh52dr.html.
360
Florida State Hospital Biennial Reports, 1954-1956, RG 841, Series 1071, pp. 32-33.
361
“People and Discoveries,” PBS,
http://www.pbs.org/wgbh/aso/databank/entries/dh52dr.html.
362
Florida State Hospital Biennial Reports, 1954-1956, RG 841, Series 1071, pp. 33.
363
Grob, p. 229.
364
Kenneth Donald Paper. Manuscripts and Archives, Yale University Library.
365
Donaldson, Kenneth, Insanity Inside Out, Crown Publishers, N.Y., 1976, pp. 13-14.
366
Ibid, p. 7.
367
Ibid, p. 96.
368
Ibid, p. 67.
369
Ibid, p. 70.
370
Ibid, p. 66.
371
Habeas Corpus,” The ‘Lectric Law Library, http://www.lectlaw.com/def/h001.htm.
372
James, Diane, Hospital Administrator, Florida State Hospital, e-mail 2/22/2010.
373
Florida's "Father of Mental Health" Immortalized at Florida State Hospital; Florida
Department of Children and Families press release, http://www.dcf.state.fl.us/news/9-14-
07FSHBuildingDedication.shtml. (2010)
374
Florida State Hospital Biennial Reports, RG 841, Series 1071, 1956-1958, p. 6.
375
Broward County History,
http://www.broward.org/Airport/NorthPerryAirport/Pages/NorthPerryNo1.aspx. (1/5/2013)
376
Florida State Hospital Biennial Reports, RG 841, Series 1071, 1956-1958, p. 84.
377
Florida State Hospital Biennial Reports, RG 841, Series 1071, 1956-1958, pp. 84, 85
378
Florida State Hospital Biennial Reports, RG 841, Series 1071, 1958-1960, pp. 91, 92.
379
Shannon, Paul, “State to Take Over Hospital, Change would Cut Costs,” Miami Herald,
March 26, 1987.
380
Germer, Fawn, “Report: Abuse Continues at SFSH ‘No Evidence’ of Treatment,’” Miami
Herald, October 6, 1988.
381
Witt, April, “S. Florida Mental Hospital to Close, Shutdown of 349-Bed Facility will take
2 to 3 Years,” Miami Herald, May 22, 1993.
382
Paez, Pablo E., Director of Corporate Relations, The GEO Group, Inc., personal email,
July 26, 2010.
383
Florida State Hospital Biennial Reports, RG 841, Series 1071, 1958-1960, p. 106.
Out of Mind, Out of Sight
235
384
Ibid, pp. 108, 118.
385
Ibid, p. 106.
386
Ibid, pp. 113, 123.
387
Report of the Director, Division of Mental Health, Covering Activities of Florida State
Hospital, Chattahoochee; G. Pierce Wood Memorial Hospital, Arcadia; South Floirda State
Hospital, Hollywood; Northeast Florida State Hospital, Macclenny. For the period July 1,
1962-June 30, 1964, p. 125.
388
Ibid, p. 127.
389
Page: 142
AP, “Legislators to Fight Prison Proposal Martinez Plan to Convert Mental Hospital
Dangerous, Lawmakers Say,” Orlando Sentinel, February 21, 1987.
390
Strobbe, Mike, “A healthy hike: State to add 120 staffers at Macclenny mental hospital,”
The Florida Times-Union, January 11, 1998.
391
About Northeast Florida State
Hospital, http://www.dcf.state.fl.us/facilities/nefsh/about.shtml.
392
Cotterell, Bill, “Mental Hospital Won’t be Privatized,” Tallahassee Democrat, May 1,
2009, p. A4.
393
About Northeast Florida State Hospital,
http://www.dcf.state.fl.us/facilities/nefsh/about.shtml. (1/5/2013)
394
Report of the Director, Division of Mental Health, Covering Activities of Florida State
Hospital, Chattahoochee; G. Pierce Wood Memorial Hospital, Arcadia; South Florida State
Hospital, Hollywood; Northeast Florida State Hospital, Macclenny, For the period July 1,
1962-June 30, 1964, p. 30.
395
Ibid, p. 31.
396
Change in Report. Report of the Director, Division of Mental Health, Covering Activities
at the Florida State Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia,
The South Florida State Hospital Hollywood, Northeast Florida State Hospital Macclenny,
For the Period 1962-1964, p. 6.
397
Final Report of the General Findings of the Committee on State Institutions Relating to
the Conditions at Florida State Hospital and the Alleged Mistreatment of Patients, May,
1961, pp. 1-2,
http://freepages.genealogy.roosweb.ancestry.com/~chattahoochee/mistreatment.htm
(1/5/2013)
398
Ibid, p. 2.
399
Ibid, pp. 3-4, 7.
400
Ibid, p. 5.
401
Testimony from Present and Former Patients at Florida State Hospital,
http://freepages.genealogy.roosweb.ancestry.com/~chattahoochee/patient-test.htm.
402
Final Report of the General Findings of the Committee on State Institutions Relating to
the Conditions at Florida State Hospital and the Alleged Mistreatment of Patients, May,
1961, p. 5,
http://freepages.genealogy.roosweb.ancestry.com/~chattahoochee/mistreatment.htm
(1/5/2013)
403
Ibid, pp. 7-8.
Sally J. Ling
236
404
Testimony from Present and Former Patients at Florida State Hospital,
http://freepages.genealogy.rootsweb.ancestry.com/~chattahoochee/patient-test.htm.
(1/5/2013)
405
Final Report of the General Findings of the Committee on State Institutions Relating to
the Conditions at Florida State Hospital and the Alleged Mistreatment of Patients, May,
1961, pp. 11-13,
http://freepages.genealogy.roosweb.ancestry.com/~chattahoochee/mistreatment.htm
(1/5/2013)
406
Report of the Director, Division of Mental Health, Covering Activities at the Florida State
Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida
State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period 1960-
1962, pp. 6, 31.
407
Report of the Director, Division of Mental Health, Covering Activities at the Florida State
Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida
State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period 1962-
1964, p. 7.
408
Williams, Bob, personal interview, 2010.
409
Ibid.
410
Report of the Director, Division of Mental Health, Covering Activities at the Florida State
Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida
State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period 1962-
1964, p. 52.
411
Report of the Director, Division of Mental Health, Covering Activities at the Florida State
Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida
State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period 1964-
1966, p. 31.
412
Ibid, p. 36.
413
Grob, pp. 288-289.
414
Ibid, pp. 289-290.
415
Minutes, Board of Commissioners, State Institutions, Florida. Volume 6, 1968-1971, p.
20.
416
Ibid.
417
Ibid, pp. 191-192.
418
Report of the Director, Division of Mental Health, Covering Activities of Florida State
Hospital, Chattahoochee; G. Pierce Wood Memorial Hospital, Arcadia; South Florida State
Hospital, Hollywood; Northeast Florida State Hospital, Macclenny For the period July 1,
1964-June 30, 1966, p. 7.
419
Ibid, p. 8.
420
Report of the Director, Division of Mental Health, Covering Activities of Florida State
Hospital, Chattahoochee; G. Pierce Wood Memorial Hospital, Arcadia; South Florida State
Hospital, Hollywood; Northeast Florida State Hospital, Macclenny For the period July 1,
1964-June 30, 1966, p. 7.
421
Cunningham, Sam, former hospital Clinical Psychologist, personal interview, 2009.
422
Report of the Director, Division of Mental Health, Covering Activities at the Florida State
Hospital Chattahoochee, the G. Pierce Wood Memorial Hospital Arcadia, The South Florida
Out of Mind, Out of Sight
237
State Hospital Hollywood, Northeast Florida State Hospital Macclenny, For the Period July
1, 1962-June 30, 1964, p. 39-40.
423
Ibid.
424
Ibid.
425
Cunningham, Sam, former hospital Clinical Psychologist, personal interview, 2009.
426
Biennial Report of the Division of Mental Health for the Period 1962-1964. Covering
activities of The Florida State Hospital Chattahoochee, The G. Pierce Wood Memorial
Hospital Arcadia, The south Florida State Hospital Hollywood, pp. 39-40.
427
Ibid, pp. 42-43.
428
Ibid, p. 48.
429
Biennial Report of the Division of Mental Health for the Period 1964-1966. Covering
activities of The Florida State Hospital Chattahoochee, The G. Pierce Wood Memorial
Hospital Arcadia, The south Florida State Hospital Hollywood, p. 31.
430
Biennial Report of the Division of Mental Health for the Period 1962-1964. Covering
activities of The Florida State Hospital Chattahoochee, The G. Pierce Wood Memorial
Hospital Arcadia, The south Florida State Hospital Hollywood, p. 44.
431
Donaldson, Kenneth, Insanity Inside Out, Crown Publishers, N.Y., 1976, pp. 144-147.
432
Ibid, p. 159.
433
O’Connor v. Donaldson, http://www.enotes.com/supreme-court-drama/o-connor-v-
donaldson. (1/5/2013)
434
Donaldson, pp. 243-244.
435
Grob, p. 278.
436
Ibid, p. 297.
437
Donaldson, p. 304.
438
Ibid, p. 295.
439
Kenneth Donaldson Papers, Manuscripts and Archives, Yale University Library.
440
O’Connor v. Donaldson, http://www.enotes.com/supreme-court-drama/o-connor-v-
donaldson. (1/5/2013)
441
Ibid, pp. 325-326.
442
Donaldson, p. 329.
443
O’Connor v. Donaldson: Supreme Court Drama, http://www.enotes.com/supreme-court-
drama/o-connor-v-donaldson. (1/5/2013)
444
Chatt-a-gram, 7/3/75.
445
Cunningham, Sam, personal interview, 2009.
446
Kenneth Donaldson Papers, Manuscripts and Archives, Yale University Library.
447
The History of the Baker Act, www.dcf.state.fl.us/programs/mentalhealth/laws/histba.pdf.
(2011)
448
Ibid.
449
Cunningham, Sam, personal interview, 2009.
450
Ibid.
451
The History of the Baker Act, www.dcf.state.fl.us/programs/mentalhealth/laws/histba.pdf.
(2011)
452
Bob Williams, personal interview 2010.
453
Ibid.
454
Ibid.
455
Cunningham, Sam, personal interview.
Sally J. Ling
238
456
“Deinstitutionalization Concept Paper” (Draft), February 17, 1978, Mental Health
Program.
457
House of Representatives Staff Analysis, h1703.fff.doc, March 23, 2004, p. 2.
458
Forensic Hospital at Chattahoochee,
http://www.dcf.state.fl.us/facilities/fsh/forensic.shtml. (1/5/2013)
459
McClellan, Melanie, Administration Assistant II, Florida State Hospital, email, January
22, 2013.
460
Florida Department of Children and Families,
http://www.dcf.state.fl.us/facilities/fsh/about.shtml. (1/5/2013)
461
Annis, Larry, personal interview, 2010.
462
Resch, Ellen, email, December 27, 2010.
463
Annis, Larry, personal interview, 2010.
464
Resch, Ellen, email, December 27, 2010.
465
Baldrige Performance Excellence Program,
http://www.nist.gov/baldrige/about/what_we_do.cfm. (1/5/2013)
466
Cotterell, Bill, “Hospital death shows threat that many face, Tallahassee Democrat,
Tallahassee, Fla: September 11, 2006, p. B1.
467
Cotterell, Bill, “Ward workers fear violent inmates: Rights of patients overshadowing
protection of staff,” The News Press, Fort Myers, Fla.: April 9, 2007, p. B3; Cotterrell, Bill,
“Hospital fight highlights problems,” Tallahassee Democrat, Tallahassee, Fl: March 13,
2007, p. A1.
468
James, Diane, email to Sally J. Ling, January 5, 2011.
469
Corbett, Nic, “Mental patients break out,” Tallahassee Democrat, Tallahassee, Fla: Feb.
21, 2009, p. A1.
470
James, Diane, email to Sally J. Ling, January 5, 2011.
471
M.E. Grenander Department of Special Collections and Archives, Archives of Public
Affairs and Policy, “Finding Aid for the Alvin Ford Collection, 1965-1995,” APAP-159,
http://library.albany.edu/speccoll/findaids/apap159.htm#history (1/5/2013); Zenoff, Elyce
H., “Can an Insane Person be Executed?,” HeinOnline, 1985-1986 Preview U.S. Sup. Ct.
Cas., pp. 465-467.
472
Malone, Dan, “Cruel and Inhumane, Executing the Mentally Ill,” Amnesty International
Magazine, Winter, 2008, http://www.amnestyusa.org/node/87240. (1/5/2013)
473
Alvord, Gary Eldon, The Commission on Capital Cases,
http://www.floridacapitalcases.state.fl.us/case_updates/041482.doc (1/5/2013); Gary Alvord,
Florida Death Row, http://crime.about.com/od/deathrow/ig/Florida-Death-Row-
Inmates/Gary-Alvord.htm (1/5/2013); Corrections Offender Network, Florida Department of
Corrections,
http://www.dc.state.fl.us/ActiveInmates/Detail.asp?Bookmark=1&From=list&SessionID=68
1150493
474
Corrections Offender Network, Florida Department of Corrections,
http://www.dc.state.fl.us/ActiveInmates/Detail.asp?Bookmark=1&From=list&SessionID=68
1135141; “Death row inmate moved to FSH,” August 26, 2009, By Staff Report:
http://www2.jcfloridan.com/news/2009/aug/26/death_row_inmate_moved_to_fsh-ar-62444/;
Montaldo, Charles, “John Huggins, Florida Death Row Inmate,”
http://crime.about.com/od/deathrow/ig/Florida-Death-Row-Inmates/John-Huggins.htm
(1/5/2013); Corrections Offender Network, Florida Department of Corrections.
Out of Mind, Out of Sight
239
475
Colarossi, Anthony, “Judge sets special meeting with death row inmate John Huggins,”
October 8, 2010, Orlando Sentinel.
476
The Numbers Count: Mental Disorders in America,” National Institute on Mental
Health, http://www.nimh.nih.gov/health/publications/the-numbers-count-mental-disorders-
in-america/index.shtml. (1/5/2013)
477
Mendoza, Rebekah Tomlinson, “Eleanor Rebecca Woodham,” “Lolo’s Story,” and
personal emails to the author, January 2010.
478
“Hospital Records: First Admissions 1933,” Federal Census for Public Mental Hospital
Reports, Florida State Hospital, RG 841 Series 1068-00001, Florida State Archives.
479
Farnhan, MD, Report of Inspection and Survey of Florida State Hospital Chattahoochee,
http://freepages.genealogy.rootsweb.ancestry.com/~chattahoochee/Farnhan.htm. (1/5/2013)
480
Ibid, p. 3.
481
Ibid, p. 2.
482
Ibid, p. 7.
483
Ibid, p. 6.
484
Ibid. p. 4.
485
Ibid, pp. 10-11.
486
Ibid, p.11.
487
Ibid, p. 13.
488
Ibid, p. 12.
489
Ibid, p. 6.
490
Ibid, pp. 13-14.
491
Ibid, p. 15.
492
Ibid, p. 3.
493
Ibid, p. 19.
494
Ibid, p. 18.
495
Ibid, p. 19.
496
Ibid, pp. 21-22.
497
Ibid, p. 22.
498
Ibid, pp. 23-24.
499
Ibid, p. 24.
500
Ibid, p. 25.
501
Ibid, pp. 26-27.
502
Ibid, pp. 28-29.
503
Ibid, p. 30.
504
Ibid, pp. 30-33.
505
Ibid, pp. 33-35.
506
Ibid, pp. 36-37.
507
Ibid, pp. 37-39.
508
Ibid, pp. 43-48.
Sally J. Ling
240
Out of Mind, Out of Sight
241
INDEX
1877 Lunacy Law, 56
Allison, Dr. H.H., 60
Alvord, Gary, 179, 180, 181
Alzheimer, Alois, 43, 149
American Civil Liberties Union,
179
Amerimanage, 141
Amnesty International Magazine,
179
Annis, Dr. Larry, 121, 169, 170
Arcadia, 119,122, 139, 142
Arsenal, 8, 19, 20, 21, 22, 23, 24,
25, 30, 56, 57, 73, 114, 146
Asylum for the Indigent Insane,
32
Ayers, Preston, 83, 86
Baker Act, 164, 165, 166, 198
Baker, Representative Maxine,
143, 164, 165, 198
Baraneau, Jim, 118
Bergal, Jenni, 118, 119
Bini Dr. Lucio, 93
Birumbaum, Dr., 160
Black Seminoles, 16
Bloodletting, 40
Bloxham, Governor William D.,
69
Bond, Dr. Thomas, 38
Bowlegs, Chief Billy, 22
Brickle, Adriana P., 60, 62
Broward, Governor Napoleon
Bonaparte, 71, 74, 139
Bryant, Governor Farris, 155
Burckhardt, Dr. Burckhardt, 98
Bureau of Refugees, Freedmen,
and Abandoned Lands, 24,
Calhoun, John C., 16, 17, 224
Carlstrom Field, 119, 120
Castiglioni, Theresa, 120, 121
Cerletti, Dr. Ugo, 93
Chaires, Benjamin, 20
Char, Dr. Wilfred J., 148
Chatt-a-gram, 162
Sally J. Ling
242
Chattahoochee, 7, 8, 11, 16, 19,
20, 21, 23, 24, 25, 26, 27, 28, 29,
30, 31, 32, 34, 35, 36, 37, 56, 60,
62, 63, 64, 65, 69, 71, 75, 79, 81,
86, 89, 105, 114, 117, 118, 119,
120, 122, 125, 126, 127, 133,
134, 135, 136, 138, 140, 141,
142, 143, 144, 145, 147, 151,
152, 153, 155, 159, 160, 161,
162, 163, 165, 166, 168, 169,
170, 175, 176, 182, 187, 188,
191, 192, 193, 196, 198, 205,
207, 217, 219, 224
Chattahoochee Arsenal, 19, 29
Chattahoochee, the movie, 163
Child Molester Act, 125
Chlorpromazine, 130, 131, 197
Christie, Dr., 72, 73
Christofoli, Peter, 80
Civil War, 23, 30, 43, 196
Coley, Representative Martin,
175
Continuous Tub Therapy, 44
Crawford, William, 54, 55
Cunningham, Sam, 117, 153,
162, 163, 164, 166
Dade, Major Francis, 21
Department of Children and
Families, 94, 134, 141
Deutsch, Albert, 112
Dickison, J.J., 36, 59, 60
Dix, Dorothea, 54
Donaldson, Kenneth, 11, 123,
132, 133, 134, 155, 156, 157,
160, 161, 162, 163, 164, 177,
198
Dorr Field, 119, 120
Drew, Governor George, 32, 63
Dry Wraps, 48
Dully, Howard, 108
ECT, 10, 92, 93, 94, 102, 130,
131, 152, 197
Embry Riddle Academy, 119
Eugenics Law, 86
Farnhan, Dr. Marynia, 86, 205,
206, 207, 208, 209, 211, 212,
213, 215
Fever Therapy, 89, 197
First Florida Infantry, 23
First Seminole War, 18, 196
Fleming, E.B., 62
Florida Division of Mental
Health, 152, 198
Florida Penitentiary, 25
Florida State Hospital, 8, 10, 11,
14, 19, 21, 30, 37, 57, 67, 70, 81,
84, 86, 88, 91, 92, 94, 101, 105,
108, 109, 111, 119, 121, 122,
123, 132, 133, 134, 135, 138,
139, 140, 143, 145, 147, 149,
152, 157, 160, 162, 163, 166,
168, 169, 170, 173, 174, 176,
Out of Mind, Out of Sight
243
177, 181, 182, 187, 191, 197,
198, 202, 205, 215, 217, 218
Florida State News, 72
Florida State Prison, 114, 177,
181, 196
Folmar, Dr., 78
Ford, Alvin Bernard, 177, 178,
179, 181
Foreman, Dr. W.B., 60, 66
Fort King, 21
Four Humors, 39, 43
Franklin, Benjamin, 38, 39
Freedmen's Bureau. See Bureau
of Refugees, Freedmen, and
Abandoned Lands
Freeman, Dr. Walter, 98, 99,
100, 101, 105, 106, 107, 109,
197, 220
G. Pierce Wood State Hospital,
119, 197, 198
Gadsden County, 16, 18, 19, 23,
31, 55, 136, 160, 175, 196, 224
Gaines, Major General Edmund
P., 14, 16, 17, 224
GEO Care, 141
Gilcrist, General, 74
Gilman,Charlotte Perkins, 61
Graham, Governor Bob, 178,
181
Graham, Percy A., 88, 89
Grob, Gerald, 37, 65, 94, 112,
130, 131, 156
Gumanis, Dr. John, 148, 161
Gwynn, Dr. V.H., 71, 72, 73
Hand Irons, 39
Hardee, Governor Cary A., 78
Hart, Ossian, 31, 221
Hills, John, 19, 21
Hills, Lieutenant John, 19,
Hogue, Attorney General D.P.,
54
Hollow Wheel, 41
Holt, General Joseph, 23, 29
Homathlemico, Red Stick Chief,
16
HRS, 118, 167
Hubbard, Dr. L.D., 44, 47, 48
Huggins, John, 181, 182, 183
Humes, Jackie Hogarth, 127,
128, 129
Huskey, Dr. A.L., 91, 92
Hydrotherapy, 43, 44, 197
Ilyankoff, Officer Dimitri
Walter, 177
Indigent Insane, 28, 36, 56, 63,
196
Insanity Inside Out, 11, 163, 198
Insulin Shock Therapy, 91, 197
Sally J. Ling
244
Jackson, Andrew, 14, 17, 18, 19,
224
Kalinowski, Dr. L.B., 93
Kennedy Shriver, Eunice, 101
Kennedy, Joseph P., 100
Kennedy, President John F., 147
Kennedy, Rosemary, 100, 197
Kirkbride, Dr. thomas Story, 50
Kneipp, Father Sebastian, 43
Kraepelin, Emil, 43
Laborit, Dr. Henri, 130
Leg Locks, 39
Leucotome, 98
Lincoln, Abraham, 23, 188
Live Oak, 32, 34, 35, 36, 72
Lobotomies, 94, 97, 101, 109
Lobotomy, 89, 94, 97, 99, 100,
101, 102, 103, 104, 105, 107,
109, 197
Lolo, 187, 188, 189, 190, 191,
192, 193, 194, 195
Lunacy Law. See 1877
Lyerly, Dr. James G., Jr., 105,
109
Lyerly, Dr. James G., Sr., 101,
102, 103, 104, 105, 108, 109,
197
Macclenny, 134, 141, 142, 143,
198
Mad-Shirts. See Straitjacket
Mallory, Stephen Russell, 23
Martin, Colonel Malachi, 26, 27,
28, 31, 32, 33, 34, 35, 196
Martin, Governor John W., 78
Martin, Weil, 100
Martinez, Governor Bob, 142
Mather, Cotton, 37, 38
Mendoza, Benjamin Alva, 81
Mendoza, Rebekah Tomlinson,
187, 188, 189
Metcalf, Ada, 61
Metrazol. See Metrazol Shock
Therapy
Metrazol Shock Therapy, 92, 197
Milton, Governor John, 23
Moniz, Dr. Antonio Egas, 98
Mount Vernon, 19, 196, 224
Mozely, W.D., 64, 65
Muhlenburg, Major Peter, 15
National Mental Health Act in
1946, 113
Neamathla, Creek Indian Chief,
14
Nine-Hole Golf Course, 117
North Perry Airfield, 139
Northeast Florida State Hospital,
134, 141
Out of Mind, Out of Sight
245
O’Connor, Dr. J.B., 155, 160,
161, 221
Operation Hope, 151
Osceola, Chief, 21, 181
Pennsylvania Hospital, 38, 49
Perry, Circuit Judge Belvin, 118
Perry, Governor Madison Starke,
23, 55
Plunge-Baths, 51
Pollock, Horatio M., 94
Pound, Dr. J.H., 83
Powell, J.C., 27, 32, 33, 34, 35
Powell, Justice Lewis, 179
Pratt, Eulish, 153
Prison Camp, 35, 84, 214
Public Works Administration, 85
Purging, 39, 41
Puusepp, Dr. Ludvig, 98
Raiford, 79, 114, 126, 177, 181,
183
Randolph, Dr. J.H., 63, 64
Rebekah. See Mendoza, Rebekah
Tomlinson
Reed, Governor Harrison, 24
Reid, Robert Raymond, 29
Reil, Johann, 41, 43
Resch, Ellen E., Ph.D., 169, 170
Restraint, 41, 87, 211
Richardson, Representtive
Curtis, 175
Rodino, Congressman, 155
Rogers, Dr. W. D., 8, 57, 134,
135, 148, 152, 155, 197, 198,
217, 218, 219, 220, 221
Roosevelt, President Franklin, 43
Rush, Dr. Benjamin, 41, 42, 49
Sabitini, Dr. M.E., 92
Sakel, Dr. Manfred, 91
School of Nursing, 115
Scotch Douche, 48
Scott, Lieutenant Richard W., 14,
15, 16, 17, 196, 224
Scull, W. J., 28
Second Seminole War, 21, 196,
224
Seminoles, 16, 17, 18, 19, 22
Shedd, Tirzah F., 61
Shower Baths and Needle
Sprays, 47
Sitz Bath, 46
Smith Kline, 131
Smith, James, 54, 55, 65, 66,
131, 142, 173
South Florida State Hospital,
134, 139, 141
Spiers, Dr. W.H., 78
St. Augustine Record, 74
Sally J. Ling
246
St. Vincent’s Hospital, 105, 218
State Board of Health, 152
Stearns, Marcellus, 31
Stone, Elizabeth T., 51
Straitjackets, 39, 41, 49
Sullivan, Dr. Edward, 101, 105,
109
Sun Sentinel, 118
Supreme Court of the United
States, 161
The Indian Removal Act, 19
The Mad Among Us. See Grob,
Gerald
The Seminole Valley Golf Club,
118
The Snake Pit, 113
The Southern Surgeon, 103
Third Seminole War, 21, 22, 196
Thompson, Wiley, 21, 118
Thorazine, 109, 130, 131, 156,
165
Three Years in a Mad House. See
Fleming, E. B.
Thronateeska, 117, 166, 197
Todd, Ferris, 79
Tomkins-Horn Picture
Arrangement Test, 126
Tomlinson, Eleanor "Lolo"
Woodham, 187
Trammell, J.W., 66, 67, 69, 70,
71, 75
Tranquilizer chair, 42
Transfusion, 40
Twirling Devices, 42
U.S. Supreme Court, 161, 177,
179, 198
Utica Crib, 41, 45, 65. 75
Virginia Eastern Asylum, 49
von Meduna, Dr. Ladislas, 92
Wagner-Jauregg, Julius, 89, 90
Walls, Dr., 113, 160
Watts, Dr. James, 98, 99, 100,
101, 107, 197
Wet Sheet Wraps or Packs, 45
Whitner, B.F., 71, 74, 75
Williams, Bob, 149, 165, 166
Williams, Calvin "Cy", 26, 27,
135, 196
Wilson, Dr. J.G., 28, 88, 89, 200
Wise, Major, 35
Women of the Asylum, 61
Woodham, Sara Martyn, 188,
193
Young Guards, 23
Yulee, Betsey, 28, 29, 30
Yulee, David Levy, 23, 29, 30,
196
Out of Mind, Out of Sight
247
Sally J. Ling
248
ABOUT THE AUTHOR
ally J. Ling, Florida’s History Detective,
is an author, speaker and historian. She
writes historical fiction and nonfiction
and specializes in little known stories of
Florida history.
As a special correspondent, Sally wrote for
the Sun Sentinel newspaper for four years and
was a contributing journalist for Boca Raton,
Gold Coast, Delray Beach, Boca Life, Jupiter and
Palm Beacher magazines.
Based upon excerpts from her book Run the
Rum In, Sally appeared in two TV
documentaries (“Gangsters” - the National
Geographic Channel, and “Prohibition and the
South Florida Connection” - WLRN, Miami).
She served as associate producer on the latter production.
She has been a guest on South Florida PBS TV and radio stations, guest
presenter at the Lifelong Learning Society at Florida Atlantic University and
Future Authors of America, and guest speaker at numerous historical societies,
libraries, organizations, and schools.
Sally lives with her husband, Chuck, and her cat, Kitty, and splits her time
between Deerfield Beach, Florida, and Wolf Laurel, North Carolina.
S
Out of Mind, Out of Sight
249
ally’s books include:
Nonfiction
Out of Mind, Out of Sight: A Revealing History of the Florida State Hospital at
Chattahoochee and Mental Health Care in Florida
Run the Rum In: South Florida during Prohibition
Small Town, Big Secrets: Inside the Boca Raton Army Airfield during World
War II (First and Second editions)
A History of Boca Raton
Fund Raising with Golf
Fiction
The Cloak: A Shea Baker Mystery (Volume I)
Phillip’s Great Adventures: Spies, Root Beer and Alligators (Children’s Novel)
For information on Sally’s current projects, to become a Preferred Reader, or to
engage her as a speaker, please visit her website at:
sallyjling.com
S
Sally J. Ling
250