Jean.
Nothing in Patterson’s notes from Donald’s sessions suggested he was capable of anything like this. Had Donald deliberately pulled the wool over Patterson’s eyes, or had he simply fallen apart without any real warning signs? Had the doctor missed something violent in him? Had he been too willing to have faith in him?
That, at least, was over. Donald had a new diagnosis. “He is probably an intelligent paranoid schizophrenic,” Patterson wrote, “who has wide mood swings from elation to depression….I think the inpatient commitment procedure is definitely the right thing to do.”
* * *
The Colorado State Hospital in Pueblo is a collection of large, bland brick buildings at the center of a town that has sprung up around it, largely to accommodate the growing staff of health care workers serving the expanding patient rolls. When the hospital first opened with about a dozen patients in October 1879 under a different name, the Colorado State Insane Asylum, the facility was just a farmhouse, and Pueblo was a sleepy town on a flat stretch of desert, a hundred miles south of Denver. The institution got its new name in 1917, having grown by then to treat more than two thousand patients—each one housed there with very little hope that they might ever be released.
The early patients at Pueblo were subject to a seemingly endless array of chemical and electric treatments designed to pacify them. In the 1920s, as the eugenics movement gained momentum, Pueblo’s doctors sterilized their female patients, despite lacking the legal authority to do so. It never seemed to occur to any of them that it might be a bad idea. “We considered it a minor operation,” the hospital’s longtime superintendent, Dr. Frank Zimmerman, said years later. “So they will not produce more mental deficients.”
By the 1950s, the hospital housed more than five thousand patients, becoming a small, largely self-sustaining community—bigger than the county seat of the biggest county in the state—with parents and children and grandchildren all going to work there at the same time. Unable to rely on the state legislature for funding, the hospital arranged for patients to grow their own crops and operate a dairy farm, a pig farm, a garden, and a factory where the patients made textiles. Pueblo had become a colony for the mentally ill, where people stayed forever; the most popular treatments in those days were electroshock therapy for depression, insulin coma therapy for schizophrenia, hydrotherapy for mania, and fever therapy for tertiary syphilis.
Only after institutions like Chestnut Lodge changed the thinking about mental illness did the brutality at Pueblo and other state hospitals start to become a subject of debate in the broader culture. One of the earliest and most powerful exposés was The Snake Pit, a 1946 semi-autobiographical novel by Mary Jane Ward—later made into a movie starring Olivia de Havilland—about experiencing scalding hot baths and electroshock therapy as a patient in a state psychiatric hospital in New York. In 1959, the Colorado State Hospital in Pueblo also became the subject of a book, a provocative roman à clef called The Caretakers, written by a former employee named Dariel Telfer. If you set aside its more sudsy, Peyton Place–like aspects, The Caretakers presented a vivid picture of some of the more popular treatment practices of the time: shock therapy, Thorazine, tranquilizers, solitary confinement, sodium luminal, sodium amytal. One character’s cavalier description of a high-security ward at the hospital is especially telling: “These are mostly psychopaths. They can do anything they’ve a mind to. Mostly they want sex and good times and liquor. They need to be kept busy on account of when they got nothing to do, they get meaner’n hell. They oughta be put to work, every single one of ’em. I got one on my ward that’s been down in restraint two weeks. According to her chart, she’s had over two hundred shock treatments. Over two hundred! Thinka that!”
A New York Times reviewer called The Caretakers a clarion call for investigation and reform. Sure enough, in 1962, a Colorado grand jury delivered a scathing thirty-page attack on the hospital in Pueblo, revealing many of the same problems that had been depicted in The Caretakers: neglect and abuse of patients; unlicensed doctors (at least one of them drunk on the job); patients escaping and running wild on the grounds. The