Elizabeth was staggered. She would—could—do no such thing. But Mrs. Hosmer was adamant: “So long as you hold these morning prayers in your room, you can never get out of this asylum.”28
Still, Mrs. Hosmer held Elizabeth’s gaze, her eyes full of some strange foreboding that Elizabeth could not interpret.
“I know more of this place than you do,”29 Mrs. Hosmer said at last.
CHAPTER 12
“Mrs. Packard… Mrs. Packard…”1
It was the patients in the lower ward again, calling to her. Conscious of McFarland’s instructions, Elizabeth walked away, but they simply raised their voices. Their pleading words followed her like fireflies: small sparks of unwelcome wonderings that glittered at the corners of her mind. Those sparks of light remained even as she walked back inside the hospital and unlocked the door to her ward.
Despite McFarland’s orders, Elizabeth had tried, in her own way, to make a small difference, as she “never could see another one in any sort of trouble without trying to help.”2 Lately, she’d begun appealing to the attendants to be kinder, hoping such a change might filter through the hospital. Elizabeth had this extraordinary ability, wherever she went, to end up the center of a great circle of friends. It had happened at the asylum too: “No one was so popular in the whole institution.”3 She’d actually become friends with some of the attendants, most of whom, by now, actually thought her sane. They talked of her “false imprisonment”;4 some even said emphatically, “She is not an insane person.”5
As such, Elizabeth knew the attendants didn’t set out to be tyrants, though some became that way. Really, they were simply overworked and underpaid. “All…we get,” she wrote, “is cross attendants who can’t wait upon us because they are so tired out, and who can’t comfort us because they have none to spare themselves.”6
It was certainly a challenging job. Attendants worked in the wards at least ten hours a day, with responsibility for up to fifteen patients each. Yet despite the long hours—and additional infringements on their personal lives, as most lived in-house—they received little remuneration, earning less than shoemakers and woodworkers. Female attendants, naturally, earned less than the men, a fact that Elizabeth adroitly pointed out. It wasn’t fair there was “so much more pay for work done by a man than when done by a woman.”7
Though McFarland had originally hoped to employ “intelligent, educated, and, at the same time, humane, attendants,”8 even he admitted his efforts had been “without success.” The staff demographic was young, poor, ill-educated, and frequently from European immigrant backgrounds; “colored races [were] of course…left out…from the list of those which might supply competent attendants.”9 But McFarland had little choice in whom he appointed. He sometimes received no applications for vacancies, with a dearth of female attendants in particular. “The unworthy,” he sighed, “may frequently be found.”10
And he was always having to recruit. The average length of service was just eight and a half months, and staff turnover was high; as much as 40 percent per year in some asylums. Indeed, attendants were so hard to come by that in one New York hospital, they recruited convicts still serving jail terms as attendants.
It was just as well that superintendents preferred to hire those with no medical training. As doctors wanted to assert their burgeoning professional authority, psychiatrists actively sought to exclude laypeople from treatment of the insane, which included attendants.
Yet another growing concern of Elizabeth’s was that there did not seem to be any treatment that she could observe. She’d assumed, before she came, that patients at the state hospital would receive “what they needed—kind, humane treatment, combined with medical skill adapted to the necessities of the case.”11 But, she said, “I never saw the sick doctored or nursed less in all my life.”12 The only treatment she’d witnessed was the occasional prescribing of “a little ale,”13 and of course the doctor’s magical “laying on of hands”14—a treatment “almost universally bestowed.”15
“I can tell you the secret of the cure of insanity, as practised here,” she wrote. “It is, ‘to do nothing at all for the insane, except to attend to their physical wants.’”16
McFarland’s own account backed up her observations. In fact, he came from a school of thought that “always acted upon the presumption that his patients needed no active treatment.”17