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Prologue: Caged










(February 19, 1969)
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Caged.

I was caged.

Then, I was driven.

Driven to Cherokee.

A hazy memory of riding caged in the back of a police car.



Two shadows in the front seat, the county sheriff and a female escort.

Patsy Cline’s “Crazy” buzzing from a tinny transistor radio.

Outside, the Iowa landscape bleak:



Cloudy and cold, condensation and frost riming the windows, piles of dirty snow dotting the countryside.

I, cargo.

Destination: Cherokee’s other place, the outline on the hill.

Shifting, crossing my legs…

Please, can we stop?

Hot and steamy inside.



Shivering, my teeth rattling.

Please…I have to go!

Hear something, George?

Naw, nothin’ important.


Laughter.

Cargo has no voice.

Madness has no voice.

Listen, crazy girl…

Two voices: We have come to take you away, ha, ha…

“I’m crazy, crazy…”

Fragments, crazy-quilt impressions, acid flashbacks…

I, crazy?



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From I, Driven: a memoir of involuntary commitment ("Prologue")


© 2008-2010, by Jennifer Semple Siegel

Excerpt may not be used or copied without author’s permission.

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Tuesday, August 19, 2008

Excerpt--A Short History of The Cherokee Mental Health Institute

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Cherokee Mental Health Institute, August 2004.
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Summer 2008

(York, Pennsylvania)



In late September 2004, I gathered my laptop, notes, photocopies of old letters to and from my ex-husband, Cherokee Mental Health: 100 Years of Serving Iowan’s (Cherokee centennial book), maps of Iowa and Cherokee, and the August 30 issue of the Chronicle Times. I carried them to Skopje, Macedonia, where I spent October 2004-May 2005 cranking out a 700-page draft.


A stranger in a strange land attempting to codify an unresolved past. Still, writing that first draft was exhilarating: I had few distractions: for eight solid months, I simply wrote.


Often tapping away eight hours a day, five days a week, I became 18 again, an odd space for a 21st century baby boomer.


Not only did old issues and angers rise up again, but after rereading my ex-husband’s letters, I even developed a slight (albeit temporary) crush on him–also compounded by the impending birth of our granddaughter Rhia, born late 2004.

Since my July 2005 return to the U.S., the revision process has presented a rockier road, ordinary life often interfering and my trying to decide what to delete and add. Because this is my story, every detail seems important, so deleting has often been problematic.

A short history of the Cherokee Mental Health Institute does feel like an important aspect of my story, but it seemed out of place in the main narrative thread, so I moved it to the end of the book and here on this blog.

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Cherokee Mental Health Institute (August 2004).
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The exterior of the Cherokee Mental Health Institute does not resemble a state hospital.

The grounds, on a gentle slope leading up to the main buildings, are stunning and kept pristine by the grounds keepers and not walled or gated from the community. In summer, a lush greenery dominates–the carpet grass is cut and watered regularly, and several varieties of trees, including conifers and deciduous types, majestically dot the landscape. Iowa trees in general tend to be sparse and scrubby, so these grounds offer an oasis, a gift to Sioux Valley Iowans, perhaps explaining their broad appeal to the community, who often use the roads as hiking trails.

Grounds of the Cherokee Mental Health Institute, August 2004.
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The buildings are over 100 years old, some of them resembling red stone and brick castles, with spires and circular annexes, but in good exterior condition.

If there is anything forbidding about the place, it can be found in its history and my commitment there. According to Cherokee Mental Health: 100 Years of Serving Iowan’s, the institution was founded in 1902 as the “Cherokee State Hospital for the Insane.” It is not a stretch, then, to view the long shadows cast by the trees and spires as sinister. Also, the red brick portion is somewhat an anomaly in Iowa, not indigenous to this area, known more for its black, loamy earth.

The facility resembles a private secondary school or even a college campus, except for one section, now used as a sex offender unit and housing 35-80 inmates. According to a Department of Human Services press release from Governor Thomas J. Vilsack’s office, the Civil Commitment Unit for Sexual Offenders (CCUSO), dedicated on September 8, 2003, has been designed to treat “dangerous sexual offenders.”

Cherokee Mental Health Institute, Sex Offender Unit, August 2004.
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“The litmus test for everything we do is safety,” said Kevin Concannon, Director of the Iowa Department of Human Services. “We’ve gone the extra mile to make sure this facility is safe for patients, safe for staff, and safe for the community.”

CCUSO is housed in a remodeled wing of the institution, the sex offenders having “no contact with patients at the mental health institute.” The section does resemble a maximum security prison, cordoned off with steel fences and barbed and razor wire, incorporating “security cameras and locks,” and mandating “special training for security personnel.”

At 18, I would have been upset about having a sex offender unit housed on the same grounds. Safety is a relative term, “safety and sex offenders” an oxymoron, no matter how many security cameras, bars, locked doors, and razor wire used. In a 2005 blurb on Online Highways, the sex offender unit is not mentioned:

Cherokee Grounds, August 2004.
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The Cherokee Mental Health Institute (MHI) is a state of Iowa psychiatric facility, operating under the Department of Human Services. The institute provides psychiatric inpatient and outpatient services. Forty-one counties in northwest Iowa are served for adult patients and fifty-five counties for children and adolescents.

The MHI is proud of its campus, The Cherokee Human Resource Center offers patients, as well as the Cherokee community, access to a hiking trail and nature study. In addition to the MHI, the campus is also home to other agencies including Synergy (Chemical Dependency) Center, The Boys’ and Girls’ Home, the YES (Youth Emergency Services) Center, Job Service of Iowa, Vocational Rehabilitation, Juvenile Court Services, and the Ecumenical Institute.

Supreme Court Building, date unknown.
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Traditional psychiatric inpatient admissions have dwindled since involuntary commitment of patients for frivolous reasons was struck down by two significant Supreme Court decisions: Humphrey v. Cady, 405 U.S. 504, 509 (1972), which ruled involuntary civil commitment to a mental institution as “a massive curtailment to liberty,” and O’Connor v. Donaldson, 422 U.S. 563, 574 (1975), which ruled that there is “no Constitutional basis for confining such [mentally ill] persons involuntarily if they are dangerous to no one and can live safely in freedom” and that the presence of mental illness “does not disqualify a person from preferring his home to the comforts of an institution.”

Evidently, incorrigible minors at Cherokee are still not accorded the same rights as adults. A May 10, 2002 Des Moines Register article reveals that

An 11-year-old boy with extreme behavioral problems is subjected to enemas, made to wear diapers and forbidden to bathe at the DHS-run Cherokee Mental Health Institute until a judge orders the procedure halted. DHS promises an investigation into the boy’s treatment. Another state agency later finds that the DHS staff implemented treatments that were “conducted in accordance with doctor’s orders.”

(For more info, click here).
Fortunately, I wasn’t incorrigible enough to be subjected to such indignities.

At the time of my involuntary commitment, my only protection was the Supreme Court decision Specht v. Patterson, 386 U.S. 605, 608 (1967), which offered legal protection at the mercy of the court system itself: “...involuntary commitment to a mental hospital, like involuntary confinement of an individual for any reason, is a deprivation of liberty which the State cannot accomplish without due process of law.” Even a neophyte can see how a lower court could (and did) interpret that decision; my court record speaks for itself.

Back in 1969, I met some the employees, many of them dedicated to serving Iowans. But Cherokee owns a sad history of warehousing the mentally ill, the incompetent, and the incorrigible. Before the two important Supreme Court decisions, people not fitting into conventional boxes prescribed by the dominant culture were often punished and hidden away.

Forgotten.

Cherokee itself simply fulfilled a mandate created by an antiquated judicial system mired in nineteenth-century wild west justice.

My residual anger lies with Woodbury County, Iowa, and the police officers, lawyers, judges, and doctors who pushed through sloppily prepared paperwork and trumped up reasons without considering a person’s constitutional rights.

I came out of my experience fairly well-adjusted, though my “inclination to conflict with social convention,” as predicted by R. Lowenberg, has persisted, for I have always believed that so-called conventional wisdom is vastly overrated. Ralph Waldo Emerson articulated the herd mentality best: “A foolish consistency is the hobgoblin of little minds.” The world needs people who would flout conventional wisdom, not warehouse and silence them.

Cherokee Grounds, late 1880's or early 1900's.
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The Cherokee book does offer some interesting history about the institution’s origins. The first superintendent, Mathew Nelson Voldeng, M.D., was hired in 1902–his beginning salary $250.00 a month. He served from 1902 to 1915 and died in 1934.

Cherokee Mental Health Institute, Staff, early 1900's.
Standing
: Dr. Long, Assistant Superintendent; Dr. Earl, Night Physician; Ella McNiven, Matron; Dr. Dragoo, Assistant Physician.
Seated: Dr. Mathew Nelson Voldeng, Superintendent; Dr. Lena Beach, Physician; Andy Rae, Farm Superintendent.

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One would not suspect Cherokee as being a hotbed of feminism, but, surprisingly, Iowa’s first female physician, Dr. Lena Beach, served there, starting in 1902, for which she was paid, as Woman Physician, $100.00 a month, less than the 1st and 2nd Assistant Physicians (presumably men), who were paid $133.33 and $116.66 respectively, but more than the 3rd Assistant Physician, paid $91.66. Somewhere, there exists a biography of Dr. Beach, this pioneer spirit who started the wheels of women’s rights rolling in Iowa.

In the early years, many of the staff lived on the campus; however, children were not allowed. Children born to employees were “farmed out to foster homes within the community to be raised.”

Now that’s workplace loyalty.

First Cherokee Patients, August 1902.
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The first eight Cherokee patients were admitted between August 15 and August 26, 1902. In late August 1902, 563 patients arrived via two trains: 310 from Independence and 253 from Clarinda. In Independence, curious citizens looked on as the stronger patients walked two miles from the hospital and the weak and sickly were transported by trolleys or hay wagons to the Cherokee train. According to the 29 August 1902 Cherokee newspaper, Clarinda offered a higher class of patient: “better dressed, better behaved and showed a little more intelligence.” More patients, 777 from Clarinda and 144 from Mt. Pleasant, were expected in the next few days.

Between 1933 and 1951, Cherokee boarded over 1,400 patients. At its peak, the institution housed over 1,700–no date is given for this number, but with the 1954 introduction of Thorazine, patient population began declining. The book offers no figures for 1969, but the population must have still been fairly substantial, for most of us had roommates.

Each patient was issued a "Ground Card"; specific privileges depended on the patient's mental health progress. For example, my privileges were fairly liberal in that I could travel the grounds by myself (without a fellow patient or staff person). I don't remember the exact wording of my card, but this looks fairly close. The date of this photo is unknown.
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Throughout the years, patients have been subjected to insulin and electric shock therapies, integral parts of Joyce’s treatment [Joyce was another patient whose name, in this memoir, has been changed].

Cherokee Patient Undergoing Hydrotherapy, date unknown.
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Straitjackets were discontinued in the early 1950's, but lobotomies were performed into the early 1970's. Had I known what a lobotomy entailed, I would have been terrified that if I didn’t behave, the procedure would be in my future. However, lobotomies were done as a last resort, reserved for the most violent patients. To my knowledge, I did not meet any lobotomy patients at Cherokee, but, at that time, I would not have been cognizant of their characteristics. I suspect that these patients were kept segregated from the general population.

Years later, I met a person who had endured a lobotomy; it was frightening to witness the damage done to him. He would simply turn on and off like a light switch, talking one minute and then drifting off into some kind of trance and then coming back, picking up exactly where he had left off.

During World War II, from February 1944 to May 1946, the Civilian Public Service Company #131, made up of conscientious objectors, served at the facility in lieu of military service. This company consisted of 25 conscientious objectors, 10 of their wives, and one sister. They served as nurses’ aides, kitchen workers, drivers, lawn and garden assistants, housekeepers, and stenographers. I would have appreciated knowing this bit of history, given my own objection to the Vietnam war and my fears for Jeff [Brown, my ex-husband] and my cousin Steve.

Cherokee Facility, Bird's Eye View, date unknown.
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At its peak, the hospital, on its 840 acres on the hill was, in itself, a small functioning town, boasting its own coal-burning power plant; a complete working farm; hospital facilities, including a dentist’s office, lab, geriatric ward, and morgue; a cemetery; a full restaurant; a butcher shop; laundry facilities; residences; carpenter and machine shops; a sewing factory; a bakery; an “amusement hall” and orchestra, made up of staff, who were often “hired on their ability to play an instrument”; a softball team; a pharmacy; and a barber and beauty shop.

Certainly, if the rest of the world disappeared, the institution could have survived, taking care of its patients and following the standard drug and psychological therapies.

The book does clarify one matter that, for years, has puzzled me: in April 1969, I spoke with a Mrs. Williams about job training in Floriculture; I could never figure out why she was pushing this career so hard, but the book reveals that Cherokee, in addition to its working farm, complete with vegetable fields, flower gardens, orchards, and beef and dairy cattle, also maintained an extensive greenhouse, overlooking the southeast section of the grounds, where the institution grew flowers and vegetables year round, even exhibiting some of their products at various state fairs.

Cherokee Exhibit at State Fair, date unknown.
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I don’t remember seeing or even hearing about this greenhouse, but I might have embarked on a career because of its existence.

Cherokee Greenhouse, date unknown.
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At various points in its history, several other training programs were offered to patients: bakery and butcher schools, to name two, and a physician residency program, for doctors just out of medical school. Currently, the facility offers a physician assistant specialty training program.

I complained bitterly about the food; in my mind, a good Cherokee meal consisted of roast beef, mashed potatoes and gravy, and peach cobbler, reserved for Sunday dinner. However, most of the time, we were served such delights as instant scrambled eggs (with a green tinge), overcooked vegetables (mushy cauliflower comes to mind), a strange meat–which I suspected was liver–and wicked coffee, often served lukewarm, so I was surprised to read about the T-bone steaks and oyster stew served during the 1960's. I don’t recall such meals, but I do remember losing a lot of weight there.

One odd, though darkly humorous, note: 100 years ago one group of female Cherokee sewing factory workers were scrutinized very carefully, for “...some medical authorities warned that professional seamstresses were apt to become sexually aroused by the steady rhythm, hour after hour, of the sewing machine’s foot pedals.”

Female Cherokee Patients Sewing, early to mid 1900's.
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Had I known that, I would have happily taken up sewing as a career path, but then the next part of this equation might have given me pause: “[These same medical authorities] recommended slipping bromide–which was thought to diminish sexual desire–into the women’s drinking water.” [In response to this “minor” reference to these women who were so cruelly treated, I was inspired to write a poem and an essay in honor of them.]

The hospital also had its own morgue, but this building was torn down in 1966, well before my time as a patient. Interestingly, the morgue was located near the Kinne Building, demolished in 1972, where the tuberculosis patients were kept. The morgue may have disappeared, but a cemetery remains on the grounds–831 patients interred between 1907 and 1962, the last a 62-year-old woman. The deceased, unclaimed by family members, were placed in wicker baskets in graves marked with numbers, for being a mental patient was considered too shameful to be made public, even after death. I never saw or heard about this cemetery–and D.J., a patient who had worked on the grounds, never mentioned it.

Cherokee Cemetery, date unknown.
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Back in 1969, I knew nothing about the morgue and cemetery, but I must have suspected something; on April 11, after recounting a frightening nightmare I had at age four, I asked, “I wonder if anyone has ever died here?” I’m glad I didn’t know; I was frightened enough about the possibility of being incarcerated for a long time and then dying in the institution.

Wicker Caskets Used to Bury Deceased Patients, date unknown.
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Chronicle-Times (Cherokee) journalist Ken Ross noted that “The cemetery is down a road beyond a locked gate. Trees surround the cemetery and Beacon Hollow Creek runs nearby.” So I wouldn’t have stumbled upon it during my walks.

In 2001, as mental illness became less of an embarrassing secret and more visitors asked to see the cemetery, the institution decided to create a memorial and formed a committee to plan the cemetery reconstruction, offering a dignified resting place for the 831 patients. In the past, when descendants visited the graveyard grounds, they were disappointed. “We were apologetic about the condition of our cemetery,” said Mike Thompson, plant manager for the institution. The project was completed in 2002 and slated for dedication in time for Cherokee’s 100th anniversary celebration on August 15, 2002, denoting the 1902 arrival of the first patient.

I don’t know how much Cherokee Mental Health: 100 Years of Serving Iowan’s really explains in terms of my time in Cherokee, but it does reveal some of the ingrained attitudes toward mental patients that still persisted in 1969. I would have liked more information about the history of the institution, including the subsequent superintendents, psychiatrists, and psychologists who practiced there, and more detail about the therapies, but confidentiality issues might have hampered the committee charged with pulling this history together.

Perhaps my story will reveal something important about Cherokee and other similar state hospitals.

Source: The CMHI Centennial Committee. Cherokee Mental Health: 100 Years of Serving Iowan’s. A Pictorial History. Iowa Department of General Services Printing Division, November 2001.

Flowers in Cherokee Greenhouse, date unknown.
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Text is copyright 2008, Jennifer Semple Siegel

Text of summary may not be reposted or republished without author's permission.
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