The head of the local brain bank came for our brains this week. At the night-time gathering in a church meeting hall, the head of NAMI local promised his attic insulation to the man in a gushing oration. My reaction to the brain collector’s pitch was somewhat different.
The researcher was polite and professional. Well-dressed. An authority figure from Big Medicine. And he was willing to come off the mountain to speak to a bunch of crazy people. Surely that was a demonstration of good faith. Shouldn’t we be grateful? Weren’t we in his debt just a little?
Yet he didn’t come without an agenda. He wanted brains. Our brains. Something to slice and study after we were gone. And while he may be motivated by sheer altruism, he may not. There’s no clear way of judging. There’s only a quagmire of uncertainty that opens up when we start giving intellectual weight to anyone’s assertions of motive. Best to understand one simple fact in this case: Brains are the man’s business.
For my part, I chose to recalibrate the debt-o-meter to zero and simply engage the researcher as an equal and a stranger. To listen critically, respectfully, without pre-judgement. Rationally. Skeptically.
The first alarm rang when he described the range of health problems that schizophrenics frequently develop — obesity and diabetes and heart disease, for starters — as attributable to their “lifestyle choices.” It nagged on me. Was it choice? Wasn’t it more of an expression of the disease itself, a symptom of simply being sick? Many of these ailments are directly linked to the medicines doctors prescribe, as his own following slide showed.
“Lifestyle choices” is how we describe those who smoke, drink heavily, and engage in risky sex. It is the language of blame. I was willing to write it off as an unfortunate misstatement before I heard what came next.
What really got me going was his displaying of an image of an squat iron cage. A “bed,” in fact, with iron bars up the sides and across the top. It was a device similar to the infamous “Utica Crib” pictured here that was used in New York State Insane Asylum system in the late 188os. The brain collector displayed this image and said calmly that it “represented the humane treatment of the day.”
No one so much as blinked.
There is so much wrong with this description it’s hard to capture quickly. Fact is, the Utica Crib and similar devices were controversial even in their time. While humane treatment options did exist for the treatment of mental illness in the 1800s (and prior, the march of medicine has in no way been unilinear), the iron cage was not one of them.
A medical doctor who took issue with the Utica Cribs in the late 1800s described them this way:
It is a bed like a child’s crib, with slatted sides, eighteen inches deep, six feet long and three feet wide. It has a slatted lid which shuts with a spring lock. A lunatic put in it can barely turn over. There is not as much space between the patient’s head and the lid as if he were in a coffin. He is kept in the crib at the will of an attendant, the key being in the possession of the latter and not of a physician. Patients have sometimes died in these cribs. DR. MYCERT, who is an authority, says the crib is a most barbarous and unscientific instrument because there is already a tendency to a determination of blood to the brain in excited forms of insanity which is increased by the horizontal position in the crib and the struggles of the patient. The crib was introduced by the superintendent of the Utica asylum. The padded room could always be substituted for the crib.
While ugly stigmas and institutionalized cruelties toward the mentally ill have existed seemingly forever, cultures throughout time have also demonstrated knowledge at different times that recovery from mental afflictions requires rest, tranquil settings, and gentleness. In fact, the birth of this country coincided with a period of reform in the Western medical world in regards to mental illness. Before the mentally ill were classified alongside those with non-curable degenerative disorders and socked away in dungeons, before the bio-mechanical triumphed over bio-energetic theories of matter, which led to more than half a century of eugenics and all the abuses that followed (including mass forced sterilizations and warehousing of the ill), there were remarkable places in countryside settings that boasted recovery rates higher than we see today. One such was the Quakers’ McLean Hospital for the Insane. It has been reported that the Worcester State Lunatic Hospital, that also sought to recreate a self-sustaining community, discharged 9 out 10 inmates as cured.
In short, we’ve both known and done better for the suffering among us. To suggest that the highest forms of torture were in fact expressions of an era’s highest “humane treatment” is not only to get history wrong but it does a disservice to history’s ill and exploited as well as those who have been struggling all along to see that the truly humane treatments become the standard. It is to insult those who still run the risk of being victimized by the dark side of today’s mental-health system, of being lost in the bureaucratic morass, mis-labeled, ignored, or simply not treated because of expense.
I stood at the end of the meeting and tried to express these things without sounding overly confrontational. My legs shook and my voice wasn’t steady, but I said my peace. Even though I wanted to run out of the room after, I even waited around. Maybe others felt the same as I did. Maybe we could have a conversation. Nothing. No one came forward. There were scraps of pizza to be picked over and brain bartering to be done.