Archive for October, 2013

Bittersweet Fruits

Tuesday, October 29th, 2013

“The penalty may be removed, the crime is eternal!”

~Ovid, Roman Poet

From 1932-1972, the U.S. Public Health Service, working with the Tuskegee Institute, conducted a clinical study in Macon County, Alabama.  The study’s stated mission mandate was to monitor, study, and determine the effects of the natural progression of untreated syphilis in rural African-American men.  All totaled: 600 men enrolled in the study.  Of these 399 had syphilis and 201 were without disease.  In exchange for their participation in the study, the men were given free medical care, meals, and free burial insurance.  Left untreated, syphilis can cause lesions, nerve damage, and in the late stages can lead to damage of the central nervous system.  They were never told they had syphilis, nor were they ever treated for it.  They were told that they were being treated for “Bad Blood.”  In 1947, penicillin had become the standard course of treatment for syphilis.  Despite this fact, the doctors continued the study without treating any participants and withholding penicillin and information about it from the patients. In addition, doctors prevented participants from accessing syphilis treatment programs available to others in the area.  The study was allowed to continue.  In July of 1972, the study was halted then officially terminated after the story broke public.  By the end of it, of the original 399 participants they began with, who had syphilis, only 74 survived.  Another 28 died of syphilis and 100 died from related complications.  Sadly, it doesn’t stop there, 40 of their wives had been infected and 19 of their children were born with congenital syphilis.  No one was ever faulted for the Tuskegee Study.

 In the wake of the fallout from the Tuskegee Study, new ethical standards were imposed preventing the abuse of patients and the system in the name of research.  This change occurred set against the backdrop of what followed in the wake of the cultural fervor and ferment of the 1960’s.  If we examine the actions of the doctors involved, we see that their actions, as heartbreaking and devastating as they are, reflect that they are to some degree the products, indeed victims, of their time and circumstances.  Or if you will allow, the product of their school.  What is interesting to note is that the character of medicine and doctors has changed in the last 40 years.  While we see their actions as paternalistic, that reflects the wisdom and judgments of the era of medicine, and its established conventions, they were operating within.  The impression that one is left with is that these doctors saw these individuals as raw materials through which they could collect data to gather results to verify, with a declared ascent, all of their interested absurdities.  To this day, the legacy of Tuskegee continues to haunt the very nature of medicine.  For this reason, as well as others, people continue to wonder whether doctors care more about their patients or the study of medicine.  This raises many questions about whether the emphasis is on care and concern for people or on scientific study and statistics.  The following video offers some insight into the ethical concerns of this.  If the sacrifice of so many men, however senseless, in the name of scientific inquiry can give society pause to reflect, then maybe there is hope for the future.  At the very least, their sacrifice will not have been in vain.

http://www.youtube.com/watch?v=HCYdI2b_9Vs

 

Filtering Reality: The Ether of An Era

Wednesday, October 23rd, 2013

What is interesting to note is that unlike the film version, Girl, Interrupted is more like looking through a scrapbook. What is also interesting to note is that this story takes place in one of the most infamous mental institutions, McLean Hospital in Belmont, Massachusetts. This institution was no stranger to some infamous patients. Among them, a Nobel Prize winning mathematician, who had his own story also turned into an Oscar winning film. A blind African-American, Grammy winning Blues and Rhythm singer. And another American author, who wrote some of the most compelling poetic prose ever done and is remembered as having helped to inspire an entire generation of feminist. Apparently they must be doing something right!

What is also fascinating to note, is that Susanna Kaysen’s stay at this hospital occurred in the period from 1967-1968. It began on the eve of the so-called Summer of Love, and ended just before the end of the Year of Hate. And she was just 19 years old. What makes this particularly fascinating is that America seemed to be on a borderline between an old way of life and a new wave of changes that would define and determine the direction and course of affairs in society. The early 1960′s were marked by a sense of great optimism and hope. Their was a genuine sense among the people of America, particularly the youth, that they could change the world. With various events, specifically assassinations, such as President Kennedy, Medgar Evers, Martin Luther King Jr., and Bobby Kennedy, by the late 60′s the cultural atmosphere had become saturated with a deep sense of disillusionment and uncertainty. So much so in fact that people seemed to be left twisting in the whirlwind. And the key question on everyone’s mind was, “What is happening to America?”

In a rather poetic sense, within this one woman’s story we see, not only the story of a place with a colorfully collected cast of characters, but, and perhaps even more importantly, we see the story of this historic intersection between where we were and where we were heading as a society. All of the dynamics and dialectic within society and many of its public and civic institutions were shifting in ways, and with a level of intensity, that most of society had never even considered before. Much like what Susanna was going through at that stage of life when she, like all of us, began to question, ponder, and explore the deeper dimensions and unexplored possibilities of existence. And as they say at the opening of the film: ” Maybe I was just crazy. Maybe it was the 60s. Or maybe I was just a girl… interrupted.” Who can say?

The following article I thought seemed appropriate to this story: http://news.yahoo.com/kennedys-vision-mental-health-never-realized-152906325.html

Sirens & Sanity

Monday, October 21st, 2013

What is interesting to note is that this collection of narratives takes place during the initial period following First-Wave Feminism. What is interesting to note is that in the period between 1920-1963 the issues concerning women and their rights seem to take a backseat. It is important to remember that women’s roles seemed to be limited to the roles of domestic affairs or clerical work. I wonder how much the idea of women challenging the status quo played a role in leading to women being unfairly institutionalized? The following link offers some historical perspective on what women accomplished during this period: http://www.infoplease.com/spot/womenstimeline2.html#WHM-1921

Mastering the Art of Medicine

Wednesday, October 16th, 2013

“Whenever a doctor cannot do good, he must be kept from doing harm.”      ~Hippocrates, The Father of Medicine

During the 1930s, one of  the most striking medical innovations was a relatively simple surgical procedure. This procedure involved severing nerve fibers of the frontal lobes of the brain. It was called the transorbital lobotomy. It was first introduced into the United States by Dr. Walter Freeman of the George Washington University Hospital in Washington D.C.. This was without comparison the most radical therapeutic procedure ever developed in psychiatry. In its day, this was considered a proper course of treatment. Today, we look back and we recoil. Dr. Freeman, in the last few years of his life, went around the country seeking out patients and trying to grasp the effects of his actions. Perhaps he was trying to prove that his efforts were not in vain.  Perhaps he was trying to redeem himself in either the eyes of his patients, his profession, or himself even. While we may look back now and say that this practice was barbaric, for all we know that course of action may have simply reflected the best knowledge of the time. Perhaps we can safely say that one generations wisdom is another generations horror. But one thing is certain, that it is an ever-evolving process. I have here a video that may offer some interesting insight.  http://www.youtube.com/watch?v=ay4goACUpBY

Incisive Insights

Wednesday, October 9th, 2013

We all carry scars. Roadmaps of the painful journeys we’ve had to endure. Unlike the distinctive hallmarks that make up the natural landscape of our of our lives, these marks carry with them lessons of a sobering nature that cannot be realized any other way. As I’ve often said, there is more of value in the experiences of trauma and tragedy than there ever is in the experiences of triumph and tribulation. While time may help to heal those wounds there is always a scar. When we see asylums now, if ever, they serve as nothing more than a painful reminder of what seems like an ancient sore that may never fully heal from the damage inflicted, which runs deep. However, it is important to remember that the road to hell is paved with good intentions. These institutions when they began were designed, at least in part, to help provide an atmosphere within which people whom were considered mentally diseased or deficient could function.

To this end, Carla Yanni in her composition The Architecture of Madness: Insane Asylums in the United States examines “the participation of architecture in this grand project to ‘bless, soothe, and restore…wondering intellects.” Her thesis, as I understood it at-least, is to demonstrate “that nineteenth-century psychiatrists considered the architecture of their hospitals, especially the planning, to be one of the most powerful tools for the treatment of the insane. Architects were challenged by this novel building type, which manifested a series of tensions between home and institution, benevolence and surveillance, medical progress and social control, nature and culture (pg. 1).”

One quote that I found particularly interesting was when Yanni pointed out that, “Asylums presented an architectural paradox. On the one hand, it was possible to assert that asylums should be unassuming and utilitarian, expressing the economic constraints of the state. On the other hand, they might better offer magnificence, thereby enhancing the hospital’s status in society and enticing the public to respect them as civic enterprises (pg. 19-20).” I find this interesting because neither part of this paradox mentions serving the interests of the patients. Caring for others is not just a business enterprise, it’s a peoples business. Also I have to say that the use of pictures was quite useful in helping the reader to envision what the time and place must have been like. Words alone are sometimes not enough in conveying information with meaning in a way that strikes an emotional chord that has resonance. I think that Yanni’s dividing the book into sections is quite useful in helping to synthesize the information. The one book that I kept thinking of as I read this is Gerald N. Grob’s Mad Among Us. I feel that Yanni’s work is really a logical extension of this growing canon of literature in the same vein as Grob. Also I thought of Nellie Bly’s Ten Days in A Mad-house. I wonder if Bly’s experience, even though it was anecdotal, was truly reflective of what went on behind the scenes of many of these institutions. If we wish to understand the significance of these institutions and their place in the history of American culture, we must understand both their physical and individual personalities. Each was as distinctive and unique as each of the individuals that shaped and informed them.

Overall, I would recommend this book as a means to advancing the growing discourse of what these places meant both in their heyday and in what they have to offer us now as we continue to grapple with the questions of how to help those who require mental help.

Sense Memories

Monday, October 7th, 2013

The term Aesthetic was first coined in 1735 to mean “the science of how things are known via the senses.”  Another way to describe it would be to say that it deals with an individual’s understanding of what seems right or appealing.  One person’s strange is another person’s normal.  While we think of these places we call asylums as strange and foreign, for those who inhabited them this was their normal.  This was the world that they had to learn to cope and function within.  And just as each of our minds is a structure that consists of a series of corridors, rooms, walls, and passageways, these asylums that these patients had to learn to navigate and negotiate their lives to, were just as dynamically diverse and individually intricate.  While there was certainly overlap in their mission mandate and functions collectively, respectively they varied in their resources and the ways in which they used them.  The following link: http://www.designboom.com/art/jeremy-harris-the-architecture-of-abandoned-american-asylums/  offers a collage of images that show the now quiet and abandoned halls of these once thriving institutions.  Now they seem to be nothing more than just a shells of their former selves.  Much like the lives of many whom walked their halls, I would imagine.  Thinking of nothing but the lives they once had.  Hollow.  Worn.  Damaged. Empty.  And Sad!

Double, Double Toil and Trouble; Fire Burn and Cauldron Bubble

Wednesday, October 2nd, 2013

To be, or not to be, that is the question:
Whether ’tis Nobler in the mind to suffer
The Slings and Arrows of outrageous Fortune,
Or to take Arms against a Sea of troubles,
And by opposing end them: to die, to sleep
No more.  ~Hamlet

I, like Ms. Tyron, had the opportunity to catch this past Sunday’s 60 Minutes.  And I have to say that I wholeheartedly concur that the segment “Imminent Danger” was really quite compelling.  Sadly though, I did not find it altogether surprising.  Since the mid-1970′s, the rates of incarceration have increased exponentially.  Unfortunately, these numbers have greatly increased, in part, due to the increased prevalence of mental disease among various segments of the population.  One thing that definitely stands out in my mind is the fact that many of these prisons operate under the presupposition that most of the inmates will, or cannot, be rehabilitated.  The emphasis of these institutions seems to be on punishment and routine as opposed to rehabilitation.  Not unlike what it was like in the Asylums in mid nineteenth century.  This is something that I feel best illustrates the meaning of that thing we Historians like to call resonance.

http://www.cbsnews.com/8301-18560_162-57605146/untreated-mental-illness-an-imminent-danger/