Asylum: A Mid-Century Madhouse and Its Lessons about Our Mentally Ill Today

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Meet Sam, the man troopers brought in because he was standing at the center of the turnpike, directing traffic, claiming to be God's police chief on earth. And Mary, a middle-aged women so obsessed with clean hands she has rubbed her palms raw and bloody. Then, too, there is Dr. Hudson Hoagland, who uses an ant farm and peppermint oil to illustrate the ancient roots of society's hostility toward schizophrenics. They are all at Worcester State Hospital, the first state insane asylum established in this nation, and the topic of Dr. Enoch Calloway's fascinating, fast-moving book about this facility that served as a model for others established later in the United States. Now a respected psychiatrist for more than 50 years, Callaway shows us with compassion and sometimes humor how the now historic mental hospital—where psychiatrists lived with the patients—was unique. The stories here are more than educational in a traditional sense; they also instruct us on the humanity of the mentally ill—and their physicians.

In his witty and warm history of Worcester State Hospital, founded in 1833 as the first state insane asylum established in this nation, Dr. Enoch Callaway reflects not just on the events in this fortress-like place, but also on how those events parallel advances and failures in the field of psychiatry itself. In addition to patient/psychiatrist vignettes showing treatment techniques of the period—from farm work to early electric shock therapy and insulin treatments that put schizophrenics in a 90-minute coma—Callaway also offers sharp insight into natural treatments that showed remarkable results and unexpected recoveries stimulated by tools as simple as a hand mirror.

At times, Worcester may seem brutal, at other times its simplicity seems pure and caring. There are marvelous successes, and times when the facility seems no more than a warehouse for the mentally ill. Callaway argues that this history offers lessons about the treatment—and options for better treatment—of the mentally ill in society today.

Throughout the text, the author weaves in comparisons to books and movies about the mentally ill and the facilities that have housed them. He includes literary works such as Madness in the Streets, Out of the Shadows and I Never Promised You a Rose Garden, as well as cinematic classics like The Snake Pit, One Flew Over the Cuckoo's Nest, and A Beautiful Mind. Each either reflects or directly opposes procedures, patients, treatments, tribulations, or compassion as they existed at Worcester.

Asylums such as Worcester were places that sheltered the mentally ill from harm they might do themselves and others, and from the criminal justice system. With asylums near extinct now, the mentally ill are again being herded into the criminal justice system where they get little to no mental health care. Can the successes and failures of a hospital that closed a half-century ago guide us toward something better? Readers from all walks of life will find this text at once absorbing, disturbing, amusing, painfully serious, and tremendously insightful.

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Editorial Reviews

From the Publisher

"Callaway looks back at those early years of training with fondness, humor, and wisdom. He asks the reader to pull up a chair, sit down, and listen to his recollections about the psychiatry of 60 years ago, see how it has evolved, and note his concerns about psychiatry today. His is a genial, generous memoir, amply illustrated with instructive anecdotes of patients and professionals who visited the hospital….As a memoir, it charmingly has much to teach the student and professional."



"Enoch Callaway has written an entertaining, idiosyncratic story of Worcester State Hospital….This is a personal history, and an opinionated one, giving it an almost conversational tone. He largely shuns jargon, and writes clearly and with humor."


Metapsychology Online

"This book is a great read, and not only for mental health professionals. It also has relevance for lawyers, lawmakers, civil planners, and administrators….Asylum: A Mid-Century Madhouse and Its Lessons About Our Mentally Ill Today consists mostly of Dr. Callaway's vivid memoirs: a more or less sequential cornucopia of many vignettes in short chapters only 2 or 3 pages long that are funny, poignant, intensley personal, and sometimes quite sharp-edged but never frivolous or lacking in common-sense perspective."


Journal of the American Medical Association

". . . frank, witty, and humane. . . . valuable in vividly revealing the personal experiences of a resident in psychiatry and the state of institutional psychiatry in mid-twentieth century America."


Lamar Soutter Library

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Product Details

  • ISBN-13: 9780275997045
  • Publisher: ABC-CLIO, Incorporated
  • Publication date: 7/30/2007
  • Edition description: New Edition
  • Pages: 216
  • Product dimensions: 6.30 (w) x 9.40 (h) x 1.10 (d)

Meet the Author

ENOCH CALLAWAY, M.D., is a semi-retired Emeritus Professor of Psychiatry at the University of California, San Francisco. A Life Fellow of the American Psychiatric Association, he continues seeing patients via contract work with companies supplying physicians to fill roles when regular doctors have planned absences. Callaway earned his medical degree at Columbia College of Physicians and Surgeons, and completed training, residencies and a fellowship at Emory University Grady Hospital, Worcester State Hospital, University of Maryland, Johns Hopkins University, and the Baltimore Psychoanalytic Institute.

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Table of Contents

Foreword     xi
Acknowledgments     xiii
Introduction     xv
In The Home For Broken Minds     1
Welcome to the Lunatic Asylum     3
Back Wards     7
Isn't That Depressing?     10
Promotion To Jesus     13
Doctor Charisma     17
Are You There?     20
Insulin Coma (aka Insulin Shock) Therapy     22
By These Signs Shall Ye Know Them     26
Electroconvulsive Therapy (ECT)     28
The Last Resort     31
Beauty Is As Beauty Does     33
Some Comments on the Subject of Schizophrenia     36
We May Be Crazy But We're Not Stupid     40
My Exhibitionism Gets a Lucky Break     42
Truth Serum     44
The Pet Paranoid     47
The Patient Who Smelled Like a Darkroom     50
Psychiatry, The Cinderella Of Medicine, before the Fairy Godmother (aka the Pharmaceutical Industry) Discovered Glass Slippers for Her Feet     53
Never Say Die     56
Folie A Deux     59
My Nose Receives a Silver Rod at Harvard     61
Doctor, Please Make The Voices Go Away     65
A Special Place     67
The Moon and Madness     71
Electronic Relics of the Pre-Penicillin Era     73
Hydrotherapy     75
The Psychoanalytic Citation     78
A Saint for the Schizophrenics     80
Deafness and Despair     83
Coarse Brain Damage     85
Psychosomatic Medicine     87
The Magic Mirror     89
The Dark Side     91
Behind the Wall of Silence     94
Gather Ye Labwear Where Ye May     97
Miscellaneous Misadventures     101
The Fortunate Failure     103
He Who Calls His Neighbor a Fool     108
The Genital Sentinel     111
Did She Die from Counter-Transference?     114
Leaders Of The Vision     119
Fabulous Phonies     121
The Psychoanalytic Innovator     125
How Fortune Came to Favor the Foundation and the Hospital     129
From Madhouse to Mansion     135
On Mink Mating and Money-Making     137
Nate Kline     139
Marvelous Mentors     141
Consensual Validation: The Movie Snake Pit     146
Footnotes on Psychotherapy     149
It's Only The Castle Burning      155
Welcome to the Third Millenium     157
Visits With Those Left Behind     161
Are Promises Made To Be Broken?     166
The Seeds of Deinstitutionalization     170
The Unholy Aliance     177
Postscript: So What? With Notes on the Culture of Caring     183
Appendix     189
Notes     191
Index     195
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