Mental Illness Treatment, a History

On Friday I caught the tail-end of an MPR conversation with Wall Street Journal reporter Michael Phillips about the use of lobotomies within the VA medical system after World War II. If doctors were unsuccessful with electroshock and other therapies in vogue at the time, some veterans were given lobotomies to "treat" everything from PTSD to schizophrenia to homosexuality. Sometimes the veterans consented. And sometimes they didn't but got one anyway.

The idea was to disconnect parts of the brain that had been creating "excessive emotions." There were two kinds of surgery: one where holes were drilled on either side of the temples so a knife could be inserted, and the other, the icepick lobotomy, where a thin tool was forced through the bone at the back of the eye socket until it entered the brain and was moved around to destroy tissue.

Phillips said on the air: "We don't know how many of them are still alive ... Often these vets did not live very long after their surgery. I don't know if that was a cause or not, but it was frequently the case. ... The VA doesn't know how many there are."

All of which reminded me of my recent visit to the Museum of Mental Health last fall. We were in Salem, Oregon, with a few hours to spare, so I looked up "Salem visitor attractions" on my phone and found mention of the museum.


As it turns out, this is the building where One Flew Over the Cuckoo's Nest was filmed. We had just enough time to see it before it closed for the day, so we found our way there.


Despite the fact that it's a small museum, taking up just a few rooms near the front door of the large building, it's overwhelming. Even a history buff who has read somewhat widely and has a pretty good idea of man's inhumanity to man can be staggered by glimpsing what people have gone through.


Maybe it's because it all appears to have been so well-meaning, unlike the treatments applied to poor black people like Elsie Lacks.


This is where I learned about the use of insulin shock therapy, which was also mentioned in the WSJ's VA story. Patients were injected with insulin to put them into an insulin (low blood sugar) coma off and on for weeks. This was popular in psychiatry during the 1940s and ’50s.


And then there's the evidence of electroshock therapy.


I'm not sure what all of the items in this photo are for, but the box at the top reads Conductive Rubber Safety Snap-on Heels. The long box at left reads Forceps, Universal and the one at right says Honed and Tested. This case was located alongside a steel raised table with a footrest and confinement straps.

Cards throughout told the stories of specific patients, such as:

Nancy Cox

31 year old housekeeper Nancy Cox was admitted to the hospital from Union on March 15, 1884. She had a diagnosis of "Acute Mania" caused by "Masturbation."

Census records show that she went from married, but separated to divorced during her forty plus years at the hospital. She was transferred to Eastern Oregon State Hospital in Pendleton after it was opened and lived there through the 1920s.

I can't tell you how many cards told of people who had lost their jobs or their farms and were committed because of depression. There was one card that said a husband committed his wife so that he could remarry.


The museum has a few props from the Cuckoo's Nest film shoot, including the Hydrotherapy Machine that's thrown by the character called Chief. Jack Nicholson's character, Murphy, can be seen here peeking through the window of a door.

In some ways I was prepared for the existence of displays about shock therapy and straitjackets. What I didn't know was the history of the many people who died in the custody of the state.

One story was of the almost 500 patients who were poisoned, accidentally, in 1942. After a patient who worked in the kitchen mistook cockroach poison for powdered milk and gave it to cooks who were preparing scrambled eggs, 47 people died.

The other story that has brought notoriety to the hospital in more recent years is the treatment of the remains of patients who died over the years and were never claimed by family. Following cremation, the remains were stored in copper canisters and placed in a basement where they stayed for decades.


Thousands of them, in varying states of oxidation. Indexed only by numbers, they were refound in 2004. They are now the subject of a documentary called Library of Dust, which was playing in the final room I visited in the museum, above a display case about the cremains.


So, wow. If you're ever near Salem, Oregon, take the time to visit this important piece of history. Allow yourself more than hour, because there's a lot more there we could have seen and absorbed if we'd had more time.