“But where are the back wards?”
This is the most often asked question by visitors to Biddle Section, Topeka State Hospital.
“People come in here expecting to find us climbing the walls and acting like some kind of monsters,” one attractive teenage girl sighed. “They look around our ward and see pretty drapes that we made ourselves, lamps, pictures on the walls, shelves filled with books and the teenagers playing records. And they can’t believe there isn’t some dark place in the hospital somewhere where patients are chained up naked.”
These attitudes are so prevalent that some of the teenagers on BH-1, a ward for adolescent girls, can’t resist teasing an understanding visitor.
Recently a group of the friendly girls clustered about a male visitor getting ready to leave.
“But we haven’t eaten you yet,” one of the girls protested roguishly.
There was a quick chorus of laughter from the teenagers and the visitor.
“We’d like the people to see us and the hospital—and to know we’re not so different. We just need help with our problems,” one girl said.
Three times a day the girls of BH-1 gather for group discussions of their problems. Sometimes it’s just a matter of normal difficulties of a group of 23 girls living together in close quarters.
But more often the group talks about serious emotional problems. With guidance of their aides, they help each other to grow in understanding and maturity. And they learn they are not alone.
Mrs. Elsie Thompson, psychiatric aide, led a recent discussion involving a more seriously ill patient.
“Mrs. Thompson,” one girl confided, “Ellen told me last night she wants to die.”
“Yes, she really did, Mrs. Thompson,” another girl seconded. “I heard her, too.”
The group previously had decided it would discuss the problems of a new patient that day and take up Ellen’s problems the following day. But Mrs. Thompson switched the course of the discussion. She looked at the 15-year-old Ellen, sitting slumped, her chin down on her chest, her gaze on the floor.
“Tell us what you said, Ellen,” she suggested.
Ellen was silent. The girls, seated in a large square, were quiet, unmoving, their eyes intent on Ellen’s downcast face.
“Hold your head up, Ellen,” Mrs. Thompson instructed gently.
Ellen lifted her chin slightly, then slumped again.
One of the girls sitting beside Ellen lifted her chin upward. Now Ellen looked at the group of watchful girls.
“Tell us what you said,” Mrs. Thompson prodded.
Now the silence went on – and on –and on. No one moved or spoke. At last it became so oppressive that Ellen mumbled something, he head low on her chest.
Speak up, Ellen,” Mrs. Thompson said. “We can’t hear you.”
The girl sitting near Ellen again propped up her chin.
“Tell us, Ellen.”
Then the words came at last, low but distant. “I –want –to—die!”
“Why do you say that, Ellen?” Mrs. Thompson’s voice was calm. But Ellen only shook her head and was silent again.
The words came at last, faintly, as from far away. “I –just—do!”
“Why do you feel that way, Ellen?”
There was another long poignant silence.
For a moment the aide paused, then asked, “How long have you felt this way?”
A long silence.
“Since—I—was—four,” came the slow, almost inaudible answer.
Mrs. Thompson’s gaze was penetrating and calm. “We’ll have to stop for today, girls. But we’ll talk tomorrow again about Ellen’s problems. I want Ellen to be thinking about why she feels that nobody cares. And I want Ellen to remember to hold her head up and speak loud enough for people to hear her.”
Later, members of the ward team explained that Ellen was beginning to work back through her feelings about an event that occurred when she was four. Ellen’s adored baby brother was feverish one night when he was put to bed. “He’ll be all right,” her parents reassured her. “It’s just a cold.” But the next morning the shocked little girl found the baby dead in his crib.
“My parents murdered him,” Ellen said bitterly when she came to the state hospital. “They let him die.”
In another portion of the Biddle Section, which has seven wards in four 50-year-old, grim-looking buildings, George’s eyes roved over the ward that had been his home for a year. And now he was getting ready to leave.
The patients of this ward had added their own colorful decorations. But nothing could really make it homelike. The hallways stretched too long and the glassed-in nursing office would be out of place in any home.
“But there’s a camaraderie here,” he said with a smile. “I’ve made a lot of good friends among the patients. There are a few real sick ones. But people really couldn’t know that most of us are patients, unless they were told.”
George, an attractive, well-dressed 28-year-old man, remembers having a terrible temper as a child.
“My mother helped me learn to control it. But I went too far the other way. Now I can’t really blow up—I just let things build up. I really don’t know how to discharge my anger.”
George’s troubles mounted, and he began taking drugs. Once he had a three-day blackout. He was on his feet, but he doesn’t remember any of that period, He only knows his boss found him standing and staring into space, and sent him home.
“I woke up—in and out of consciousness—in a general hospital, with a locked door and rails up around my bed. The nurses looked at me from the doorway. They wouldn’t even come in the room—they were afraid I might turn violent.
“Then the sheriff came into the room and told me my wife had signed commitment papers. I told him, “Oh, no, not my wife! She wouldn’t do anything like that.” But I found she had. I was bitter at first but then quickly I decided I needed help and worked hard at it.”
George paused as a slender man with a friendly smile walked up and handed the visitor a slip of paper. Written on it was, “Michael Francis Lipton. Age 32.”
“That’s me! Mike said proudly. “I’m 32. 32.”
He extended his hand in a cool, flabby handshake. His smile was infectious and genuinely warm.
I like pork and beans,” he said, the smile never leaving his face. “Pork and beans. I like tomatoes. I like potatoes. I like potato ships (chips). Potato ships. I’m 32. 32. I like pork and beans. In the red can. Pork and beans. I like tomatoes, I like potatoes. I like potato ships.”
The laughter of nearby patients was friendly. They, like George, have developed a protectiveness toward Mike and other extremely ill patients.
“Sit down, Mike,” George said gently. Sit down, Mike.”
“Why don’t you go see if it’s time for a cigarette?” one suggested. Instantly Mike strode off to the nursing station at the middle of the ward.
“Is it 6 o’clock? Is it 6 o’clock?”
“Not yet,’’ an aide said patiently, with a smile.
Mike wandered off to wait for the time for his next cigarette. George continued talking, reflectively.
“I didn’t know much about mental hospitals before I came here. I think Biddle is doing a good job. We patients really appreciate the volunteers who come here. But most people just don’t know what it’s like here. I think more people would come if they knew what it’s really like.” He glanced across the room and exchanged smiles with a couple of patients. Even families don’t always understand, George said.
“My mother wouldn’t come on the ward. I have to go on the grounds to talk to her. I’ve told her I’d like her to meet some of my friends on the ward. Once on the grounds we met another patient from this ward who said “Hi” to me. My mother said he didn’t even look sick. But she still was afraid to come to the ward.
“I’ll be back if I have any troubles,” he said with determination. “I know now I can get help.”
George pointed out a former lawyer, rapidly pacing the room, back and forth. “He paces more when he’s upset,” George said. “He’s been ill since his brother died 15 years ago. John, over there in the wheel chair doesn’t talk at all. He was badly injured in an automobile accident.”
But the chronically ill ones are few in number. Most of the patients are busy with their jobs, or school, or therapy activities such as painting and making things from wood.
The spark and moving spirit of Biddle is Dr. James B. Horne, the section chief. He’s deceptive, quiet, warm and responsive; his hands are busy constantly relighting his pipe. Dr. Horne likes straight dealing and dislikes pussy-footing –either from staff or patients. There’s a spirited give-and-take in section meetings. When Dr. Horne doesn’t like something, he lets the staff know. And when they’re unhappy, they let him have it between the eyes. Perhaps that’s why Biddle has such high morale and loyalty.
The staff glows with elation about its work with some difficult patients. It’s a triumph for the entire psychiatric team—and that’s everyone on the ward – when a schizophrenic teenager is admitted and then several years later ends up as someone who is just plain ordinary.
Biddle Section uses “milieu therapy” – an attempt to set up a 24-hour daily environment in which everyone who comes into contact with the patient contributes to his treatment.
Biddle Section staff is enthusiastic about its dynamic psychiatric team concept, in which information about the patients constantly streams into the meetings from everyone who sees the patient.
When major decisions are made about how to treat a patient, the entire team makes them. The psychiatric aides, with their close day-to-day contact with the patients, are key figures in the psychiatric team. They keep the professionals informed about what’s going on and carry out the team prescription for treatment.
Perhaps because the mental health profession naturally is analytically minded, Biddle can never rid itself of its nagging, bone-deep guilt that, while good treatment is going on, there is not enough of it for some patients. A lot of patients get better, but not cured. Treatment doesn’t succeed with some patients because there wasn’t enough personnel or no social worker was available to work closely enough with the family.
Some patients leave the hospital still angry – but not acutely angry. They will say, “Treatment was the roughest thing in my life. I hated my doctor. And I detested that charge aide.” Despite this, they are grateful to staff for helping them – grateful and forgiving.
“But we don’t get that far with most of our sick patients,” Dr. Horne said thoughtfully. “They leave angry with us for hurting them and thinking they will be damned if we’ve done anything to help them.”
He mused, “We have to be ready to be tough and blunt with them. We say, ‘It would be beautiful if we could be taken care of, warmed, fed and loved, and if we wouldn’t have to do a damned thing to earn affection. Yes, it would be. But what’s it cost you? How old are you? In this world how can you get what you’re wanting, what all of us want – how can you get it?”
Some of them, those who are fearful, will settle for the hospital, if the staff lets them.
But Dr. Horne said he tells such a patient, “If you have all four extremities chopped off, somebody will take care of you. But how would you like to be that kind of basket case? Or, how would you like to be a patient in a mental hospital all your life?”
“If you’re willing to scrap what pride you have in yourself and just be taken care of – yes, it is possible. But it will cost you a lot in self pride. You will have to be a completely helpless patient.”
“Patients get well largely because we push like hell for them to choose between alternatives – and we don’t pull any punches about which I the sickest alternative or most sensible.”
With a slight grin, he added, “We make it damned uncomfortable to stay sick – and much nicer to get well.”
A young woman who had been in the hospital 12 years was assigned to Dr. Horne’s ward. Many psychiatric teams had tackled her in the past, unsuccessfully.
“I had heard about her from others,” he said. “Periodically she would get a real bitter streak and would have to be restricted. I decided on a new tactic. When she tackled me to talk to her about her problems, I would not talk to her. I told her, ‘You’ve been talking about your problems 12 years. What’s keeping you in the hospital?”
“Then we moved to “Your parents made you sick? So you’re going to stay in a mental hospital the rest of your life to pay them back for making you sick?”
A competent aide joined forces with Dr. Horne in hammering away at the woman.
“When a patient is disorganized, you want to put her back together.” Dr. Horne said gently, his hands making a “bunching up” movement. “But I had to be awfully ready to be blunt with her. “You’re acting like a chronic patient. Don’t you make me slam that door in your face.’ But the aide did the work. If she hadn’t been able to restate and do all the working out, my hollering at the patient two or three times a month wouldn’t have changed a thing.”
The woman began to improve and decided she wanted to visit her parents.
“There was a little flurry back home,” Dr. Horne said. “She came back upset. But I told her, ‘Love overflowing you’re never going to get.’ I asked her if there wasn’t some little thing she enjoyed about the visit – even the food? Yes, she had liked the food. I said, ‘Great! That’s as good as it gets!’”
The patient decided at last she could forgive he parents and give up revenge. She was able to leave the hospital – and stay out.
Dr. Horne regretfully acknowledged that “Sometimes there are patients who, with the very best treatment, don’t make it. I think you have to give it a hell of a try – and then accept what you get.”
But he still will argue that this does not mean because he cannot reach a patient that some other doctor – or aide or nurse – could not, either now or in the future.
“The Menninger hospital has less of a team treatment than we do. When I came to Biddle I found aides, nurses and adjunctive therapists who can treat patients. This isn’t usual at Menninger’s, because there are too many psychiatrists and psychologists around.
“At Biddle, we treat some patients better than the Menninger hospital does, some of the time. And Biddle Section has more group psychotherapy than any other section at Topeka State Hospital.”
Osage County Probate Court Judge Frank Garrett says the Biddle treatment program “is most excellent in every phase of its operation.” Admissions have been well handled, he said, and without undue delay.
“The program reflects the personality and sincerity of purpose of Dr. Horne,” Judge Garrett said.
Judge Garrett has a well-earned reputation of being able to spot early signs of possible mental illness. He has sent many persons to Biddle for treatment before their illness could become overwhelming.
Biddle is one of three adult in-patient treatment centers at Topeka State Hospital. Together, the three sections serve patients from northeast and north-central parts of the state. The other two sections are Eastman and Woodsview.
In all, there are six sections of Topeka State Hospital. Three are specialized – two for treatment of children, one in applied research.
Biddle is the last of three TSH treatment sections to be housed in old buildings.
While Biddle longs for beautiful surroundings and quarters hand-tailored for modern treatment, it still hangs its hopes mostly on getting more staff.
“We’re so close to the edge all the time,” Dr. Horne sighs.
With one more aide per shift for each ward – two additional aides – Biddle could prevent the desperately short staffing when some aides have days off, some are on vacation, and some are ill –simultaneously.
One more psychiatrist would ease the load of Chief Psychologist Dr. Robert Proctor and his co-workers, permitting more testing of patients, more individual and group therapy, and permit time for more analyzing of the treatment program and its effects on different patients.
The section has four psychiatrists. But Dr. Horne said a fifth would help in the tremendous amount of work required in management of a 242-bed section with an intensive program that makes possible more than 280 admissions each year.
Biddle Section really needs seven or eight social workers, but it has only three.
Treatment has changed at Biddle – and must continue to change – because of the increasing load of youthful patients coming into the hospital. Their energy and drive require higher staffing and different activities. The median age of Biddle patients is 29 years.
Recovered patients sometimes tell the team how it felt when they were in the throes of their illness.
“It was like being behind a glass wall,” one boy recalled.
Another said it was “feeling like you’re not wide awake – like you do when you open your eyes in the morning and see something in the corner and are not quite sure whether you’re dreaming.”
A third compared it to “being at the head of a staircase and coming down to the landing to look down at other people.”
Blaine – a slim young man who looks at people with a strange sideglance – has been hospitalized 11years. Severely disoriented, he has been ill almost since he was born.
Blaine walked up to the visitor. His handshake was limp and cool.
“Would you read this?” he asked softly.
On the sheet of ruled paper were some questions, including; “Do you think the world will be destroyed by fire?” and “Can there ever be heaven on earth?”
The visitor could only shake her head and say, “I don’t know, Blaine.”
The young man seemed more like a child than a 22-year-old man. Often Blaine lapsed into long silences. Occasionally he yawned. His eyes and voice were sleepy and languid.
“Do you have some friends, Blaine?”
His eyes lit up. “Yes, I have one friend.”
“And now you have two friends, Blaine,” the visitor said softly.
Blaine smiled responsively – but didn’t really believe.
“Do you think I’ll be here all my life?” he asked his new friend.
“No,” the visitor said positively. “You’ll get well.”
“I don’t think so,” Blaine said, with mounting sadness.
Then with an abrupt shift of thought, he asked, “How long do you think the world will last?”
“I don’t know, Blaine.”
He stole a sidewise glance at the visitor. “Do you think the world will last for thousands of years?”
“I don’t know. Perhaps.”
“I’m Jesus Christ. I can never die until the end of the world comes. So I’ll have to suffer for thousands of years.” His eyes were tortured, resigned. “Do you think the world will last for billions of years?”
“I don’t know, Blaine. No one knows.”
“Then I’ll have to suffer for billions of years.”
“Perhaps it won’t be that long,” the visitor offered.
Blaine’s eyes brightened abruptly. “You mean I’ll die?” he asked with avid interest.
“No,” the visitor said firmly. “I mean you’ll get well.”
The light died from his eyes. He shook his head and sat silent, brooding. “The world is so full of evil.”
“You’ll have to work hard at getting well, Blaine,” the visitor scolded gently. “And then there’ll be some good days ahead. You’re too young to spend the rest of your life in a mental hospital.”
“I’ve never had a good day,” Blaine offered in his soft, emotionless voice.
“Haven’t you really? Not ever?” the visitor asked.
“No, not ever.”
“But you do have two friends now, don’t you?”
Blaine’s smile was sudden and radiant.
Then he wandered off to sit on the bottom steps of the big staircase, once more remote in his own private little world.
After weeks of planning and hard work on booths, the BH-3 carnival was under way.
The band played loudly, and the dancing was carefree. But under the surface there was deep disturbance in the Biddle patients.
That day Dr. Horne had announced a major change in Biddle Section. The old Stone building, housing Ward E and Ward F would be torn down, because it was a fire hazard.
By July, Ward E patients and its staff would move to BH-3 quarters. BH-3 would move to D cottage.
This meant that the D Cottage women would have to make room for the men of Ward E.
In addition, Ward F patients and staff would move to BH-4 quarters, and that ward in turn would take over one floor of F Cottage.
Instead of 45 to 50 patients, in July, F Cottage will house 69 to 78. D Cottage’s patient load, instead of being 40, will go up to 65 to 75.
Only BH-1, for adolescent girls, would be undisturbed.
Staff members, too, were disturbed. They worried about the crowding. Where they would put all the beds. Where the patients would find room for activities when part of the day halls were taken up by the beds. And how they could possibly reduce the patient population sufficiently by July to make the transition.
“I don’t see how they’ll squeeze us all in,” one man said. “I suppose it will be nice to be in the same building with the women, even if we are in different wards. We don’t see women very much, and sometimes we forget how to talk to them.”
Another patient worried about the lack of storage space and said he would have to send most of his clothing home.
Most unhappy of all were the women of BH-4 who had beautifully decorated their ward with a shag run, swag lamp, bookcases, and specially made curtains. Now they would have to do the job all over again.
Paul – a tanned, restless outdoorsman – was eager to talk.
“It’s nice to talk to someone who isn’t staff,” he said with a quick smile. “I’m used to being outside most of the time. I’ve been here six weeks, and they haven’t let me outside the door once. I’m not violent. And I’d never run away. They always bring you back. I can’t stand this being locked up. I think I’m worse now than when I came. And I don’t think there’ll be anything left of me when three months are up.”
Longingly he looked at the open door, with the green expanse stretching out under the trees. But he, like other patients restricted to the ward, made no move to attempt to go outside. It was against the rules.
He asked anxiously, “Have you heard about my tests? No one ever tells me anything.”
With deep depression in his tones, he said, “I’d feel better if I could just walk outside, even if I had someone with me.”
He added, “I don’t really know what my problem is. I wish someone could tell me.”
A second visit with Paul a few weeks later found him much more relaxed. He was receiving medication and was allowed to go out on the grounds by himself.
“I’d like to go home soon,” Paul said. “I’m better now. But I still don’t know what my problem is. I wish someone could tell me what it is.”
In one of the women’s wards a severely ill woman, hospitalized 50 years, mopped the floor over and over again, occasionally shouting, “GANGRENE!...MURDER!...GANGRENE!”
Another woman curled up in a butterfly chair as though in her mother’s womb. She doesn’t talk.
One chronic patient at intervals called people “asses,” muttered or talked loudly, and then finally went to sleep on a couch.
Erma, looking about the ward as if to try to see it as the visitor was seeing it, commented softly, “We worry about what you’ll remember most about our ward. There are a few who are sick. It’s easier to notice the sick ones – and to overlook those of us who are getting well.”
Jane, a seriously disoriented patient, wandered up with a sweet, rather remote smile.
“Would you like to see my dolly?” she asked.
Then she took the visitor to her bedroom, which she shared with three other women. On her dresser was a small, beautifully dressed doll in a hoop skirt of blue nylon net trimmed with delicate flowers.
When the visitor praised the doll, Jane immediately handed it to her and said, “I’ll give it to you. Because you saved my life.”
“I have a baby,” Jane said. “It was a little boy –or maybe a little girl. I can’t remember.”
“How nice! When did you have your baby?”
“This morning,” Jane said, with a proud smile.
Jane has been hospitalized for years. She cries often, without apparent reason.
Showing a picture she had drawn, Jane said, “I’m very talented. Sometimes I don’t like to talk,” she told the visitor. Then she closed her eyes and sat motionless, as though asleep.
Down at the center of the attractively decorated day hall, Selma Harwood screamed at an aide: “I don’t want to go to the circus in an angry crowd of blue collar, unintelligent, misinformed, loutish people. Circuses are for kids. At that performance there’ll be just kids and Topeka State Hospital patients.”
“Is it true? Dr. Horne is leaving us to be section chief at Woodsview?”
The report spread fast and furiously.
Dr. Horne quickly confirmed it. Dr. Ian Graham was leaving Woodsview Section to return to Canada. Dr. Horne had been offered the challenging opportunity to run a section specializing in the training of young psychiatrists from the Menninger Foundation.
Biddle has had a long succession of section chiefs, with Dr. Raphael De Soignie, now of Kansas Neurological Institute, staying the longest—about six years. Some personnel who had been part of the original old Stone Section that was merged into Biddle Section, have had seven section chiefs in six years.
Dr. Horne has had charge of Biddle the last 18 months.
Biddle, which has been swept along by the enthusiasm and vision of Dr. Horne, once again faced the reality of change and disruption.
Who would be the new Biddle section chief? No one knew. No one could even guess. The patients and staff were both angry and sad.
For them both it was a second heavy blow, following so soon after the new of the coming move. But the staff carefully concealed its own upheaval, knowing the patients needed their stability to cling to.
Along with the news of the move and Dr. Horne’s new appointment came the disquieting report that Dr. Alfred Bay, hospital superintendent, had resigned. Biddle Section, at its hospital carnival, had much to ponder.
One of the topics of discussion at a ward team meeting was whether the door of this ward should be left open for a few hours each day. Any decision was deferred.
Selma Harwood’s rebellion against going to the circus was brought up.
Dr. Kathryn Rainbow, ward psychiatrist, said she did not believe Mrs. Harwood should have to go to the circus.
“This lady is saying – loud and clear –that she is frightened to go to a circus where there is noise and confusion, when she can’t even handle the confusion in her own mind. And perhaps there are other patients on the ward who have been unable to tell us so clearly as Mrs. Harwood,” Dr. Rainbow said.
Other members of the team agreed.
The staff discussed Selma’s way of cutting people down, of trying to make others feel inferior to her.
" She’s giving us her message. Keep hammering at her: ‘I know what you are telling me with all your kinds of behavior – that you are unable to have a good relationship with anybody.’ She will cut you down. But it is like trying to rescue a little kitten from a tree limb. Whenever you reach up to grab it, it will scratch you – and scratch you – and scratch you. Mrs. Harwood will scratch, too.”
There are many small patient groups that meet regularly in Biddle. They’re listed as music therapy, current events, and other discussion groups. But all of them are much more than just that.
Somehow all of them get involved in talking about problems and ways of getting well. They talk about their fears in coming into their hospital – and their fears in returning to their home communities where people might look down on them and not understand.
One woman, speaking softly, said she was quite ill when she was admitted.
“I didn’t know the difference between what was real and what was not,” she said. “But I’ve improved now. Just recently my children have begun to look at me without terror in their eyes – terror not for what had been in the past or the present, but for what might be.”
Maria, who is 25, said she has been ill since she was five.
“That’s almost all my life,” she said. “I never had love in my home when I was growing up.”
She spoke about an aide, Mrs. Betty Turner.
“Mrs. Turner is wonderful,” she said wistfully. “She has such a sense of security. I just wanted to follow her around all the time and be with her, so some of that security might rub off on me.”
One young girl said she wishes other people could understand mental illness better.
“My parents don’t understand that I’m mentally ill. They look at me and say, ‘But you look so well! Why can’t you come home?’” I know I look just like everyone else outside the hospital – but I know I need to be here. It took me a year to admit to myself that I needed help.”
Leaving a child – or any other relative – at the state hospital is a traumatic experience.
Tom and Laura Hanson sat in their parked car for an hour afterward, unable to start the long drive home.
They had brought 14-year-old Sally here – but leaving her was something else again.
Mental illness was something outside the experience of the Hansons. They’re a friendly, attractive couple; devoted parents. They own their own home and live comfortably, are actively involved in their church.
Their older daughters had adjusted to the problems of adolescence. But then along came Sally – shy, withdrawn, living in a fantasy world.
Problems mounted but came to a head on the day Sally told her family she felt so bad at times that she thought of taking her own life – and asked for help.
A psychiatrist said Sally should be admitted to Topeka State Hospital. The parents considered mortgaging their home and trying to get Sally into the Menninger Hospital – but the doctor told them they could not afford it, and that Sally would get good treatment at Biddle Section.
“Oh, the blow when he told us she should be in the state hospital!” Mrs. Hanson recalled. “I couldn’t realize how we could have lived in the same house and not have realized what was happening to Sally.”
Her husband added, “People tell you about their experiences –people who have been there. But you really don’t know. It really doesn’t come home to you until it happens to your own family. I’ll tell you that for sure!”
Their first impression of Biddle was “terrible.”
“We felt as though we were putting Sally in prison,” Mrs. Hanson said.
The goodbyes were poignant. It was the first time Sally had ever spent a night away from home. All had tears in their eyes.
But they gave Biddle a chance. And now, two years later, Sally is almost well. She’s even talking about going to college.
Through the ups and downs of Sally’s treatment, the parents alternately clung to and fought the Biddle Section chief social worker, Lorraine Galle. She worked ceaselessly to help Sally and her parents understand each other and to help the psychiatric team understand the parents.
Getting well, for Sally, required the efforts of her parents as well as those of a skilled psychiatric team.
Dr. Jim Horne walked briskly along the well-lit sidewalks at 9 p.m., with the old, forbidding-looking buildings of Biddle Section providing a shadowy background.
The only sounds in the quiet night were the eerie chatter of his footsteps and the faint rustling of the trees in the wind.
It would be 4 a.m. before Dr. Horne would head toward his own home after making night rounds of all the seven wards on Biddle.
Patients go to bed early on Biddle Section – usually by 9 or 9:30 p.m., except on weekends, when they may stay up later.
When Dr. Horne began his rounds, he found a few patients in pajamas and robes, preparing for bed. But by the time he visited a couple of wards the patients had retired, and Dr. Horne and the night staff were left alone in the great, long halls, dimly lit, for quiet conversation.
Only the occasional crying of a patient in one of the dormitories or the appearance of a pajama-clad, disoriented patient who imagined she heard voices interrupted the talks.
In one of the dim dormitories, a young suicidal woman lay sleeping, heavily sedated. Her arms were outstretched from the shoulder, the wrists confined by soft-lines restraints. Beneath the sheet, at the foot of the bed, her feet were also in similar restraints.
A few days before she had written a poignant suicide note to staff.
“There is no other way.” Please tell my family I love them.”
She gave the note to another patient to give to staff. Then she broke out a window and began slashing her wrists.
The staff was able to save her – and now had begun the task of trying to prevent her from harming herself until her will to live could be restored.
One young teenager, up a little later than most, talked eagerly to a male aide. Recently arrived a Biddle Section, he seemed to be reaching out for companionship, so he need not be alone in the night hours.
Tall, serious, he still seemed a little dazed, somewhat like a sleepwalker.
He said he has “flashbacks” from having taken LSD in the past.
His terror of the “flashbacks” undoubtedly leads him to seek conversations with aides often.
Soon after arrival at the hospital he frantically told an aide: “I’m turning into rubber.” Then he began bouncing around the ward, until the flashback was spent.
Then within a few hours, another “flashback” shook him.
He ran up to an side and begged, “Please put me into seclusion. I’m afraid I’m turning into some kind of animal and I’ll start breaking windows and furniture.”
Instantly the aide took him into one of the seclusion rooms.
“Within seconds he went into a deep apparent sleep,” she said. “I went back at intervals to check him to be sure he was breathing all right. A couple of hours later when I was checking him, I found him lying on his back, his eyes all bloodshot. He said, ‘Do I have to come out now?’ I said, no, not if he didn’t want to. So he stayed in the seclusion room the rest of the day.”
Dr. Horne knew this night would be a talkative one.
The staff was upset about Civil Service job descriptions which had just been issued, listing aides’ duties as sweeping, mopping, dusting, and similar tasks. The descriptions mentioned nothing about the aides’ important role in treating patients.
Dr. Horne knew there would be some explosions – and he was in complete sympathy.
The atmosphere at night was relaxed and friendly. Some of the old-time night staff offered him some hot coffee. One aide gave him a slice of homemade bread.
The aides were filled with the uncertainty that Biddle seems to live with from day to day.
The move of patients was uppermost in their minds. Did he know yet when it would begin? How will they manage with so many patients? Surely the Legislature will not cut down their aide positions when Stone building is torn down. And how can they ever help the Legislature understand how desperately more aides are needed?
There were many little side glances toward Dr. Horne, who once more was overburdened with the duties of section chief and responsibilities as ward doctor for three wards. Dr. Cesar Jardon, who had been welcomed so eagerly only a few months before, suddenly had said he must go to Spain for a three-month leave.
Now Dr. Horne had to face the decision of whether he could really leave Biddle in the lurch, with only two psychiatrists, Dr. Rainbow and Dr. Lee Johnson, and no section chief.
For several nights he had lain awake, mulling over the situation.
The problem dwelt in his mind even as he talked to the night aides, listened quietly, fussed with his pipe, occasionally chuckled at the humor of the aides.
At last, at 4 a.m., a tired Dr. Horne left the last cottage, carefully locking the door behind him.
He stole a backward glance at Biddle, its outline softened by moonlight through the trees.
He knew there really had never been any doubt about his eventual decision.
He could not leave Biddle until it had a new section chief. And if that decision cost him the Woodsview section chief appointment – then so be it.
by Stannie Anderson
Midway, June 7, 1970
Giving life back to the living
Dr. James B. Horne, Biddle section chief