Times Record/Roane County Reporter
State Hospital story began on a note of hope
July 6, 1989
With the closure of Spencer State Hospital last week, an important chapter in the history of Roane County and West Virginia came to a close. This continuing series will examine that history, beginning with the hospital's early years.
The state's Second Hospital for the Insane was opened on July 18, 1893. It came in a time of increasing prosperity for Roane County, colliding with the arrival of the railroad and the invention of equipment allowing the development of the oil and natural gas reserves beneath the land. Its location in Spencer was instrumental in establishing the county's first bank.
The state legislature's decision on where to locate the hospital was drawn out for two years. During that time, citizens' meetings were held and committees were formed to promote Spencer as a location for the facility, much as, nearly a century later, residents would band together in an attempt to save the institution. A three-man delegation was chosen to attend the special session during which the final choice of a site would be made, assisting Roane County's representatives in their lobbying efforts. "It was a very suspenseful time for Spencer," wrote Jim Mylott in his history of Roane County, A Meaure of Prosperity.
Today, it seems, we have drained the dregs of that measure as, in a time of economic crisis, the hospital has been closed by an action of the state government, even as it was created over 100 years ago. It has again been a suspenseful time for Spencer. After over a decade of controversy, Spencer State Hospital stands silent and empty on the hillside overlooking town.
As one explores the hospital's past, a story unfolds of a hard- working, low-paid staff who cared for their patients as if they were members of their own families, even though they lacked the training and numbers to offer whatever actual therapy was mandated by each new trend in mental health over the years. A story emerges of the quest for humane treatment for victims of mental illness and retardation and those who fought to make this ideal a reality in West Virginia. The hospital's recent history reveals the effects at the personal, local and slate level of the implementation of a federal government policy requiring deinstitutionalization of mental patients, hailed as progressive by some, and called a resignation from responsibility by others. There is also a story of state officials more concerned with economics than human suffering, whose inept decisions resulted in the suffering and even death of the most helpless segment of the state's population. In the past 12 years the mentally ill and retarded have been herded like animals from institution to institution, according to plans which changed too frequently and in whose making they had no voice.
But the story of Spencer State Hospital begins on a note of hope. Perhaps hope and progress and a measure of prosperity will come again.
The state legislature began seeking a site for another institution in 1885 when crowded conditions at the first state asylum, opened at Weston in 1864, demonstrated the need for an additional facility. They appointed a commission to choose and investigate several sites and present their findings at the next session in 1887. John G. Schilling, a Spencer attorney, was among the members of the commission.
Although it was not one of the communities originally considered, Spencer was eventually chosen as the site for the new hospital in 1887. The legislature approved an initial appropriation of $10,000 to begin construction.
The county, in turn, was required to provide the land for the facility. In February 1888 the Roane County Court, now the county commission, purchased 184 acres from William R. Goff for $9,200. Although there are many stories that the deed specified that the property would return to Goff if the state institution were ever to close, the deed on record at the courthouse contains no such language.
Goff, seeking a safe repository for the large sum of money he received, joined together with other citizens to form the Bank of Spencer, which opened its doors for business in March 1891 with a capital stock of $50,000. As construction of the hospital began, the county's first bank was designated a state depository for disbursement of construction funds, and later for the regular transactions of the state institution.
The gothic hospital structure, nearly a quarter of a mile long, was built from bricks made on the grounds and stone from a local quarry. Its slate roof was adorned at intervals with whimsical cupolas typical of the period. At its center stood a four-story administration building, graced with two round towers. Sweeping out from each side were the two three-story wards, one for men and one for women.
At the time of the opening, 54 patients were admitted to the new facility. By 1899 the population had increased to 389 and in 1910, to 696.
Listed in the 1910 State Board of Control Report, issued biennially to document the status of all state operated institutions, are the disorders for which patients were admitted to the hospital between October 1908 and October 1909. These included alcoholic excess, senility, hereditary insanity, worry, ill health, over work, head and other injuries, syphilis, epilepsy, paralysis, morphia, cocaine use, chorea, disease of the uterus, pneumonia, bereavement, typhoid fever, tuberculosis and puerperal disorders, once called childbed fever.
The same report describes the "open door" system, implemented some time during the first ten years of the facility's existence. No doors to the patients' rooms were ever locked and half the doors in the men's ward had been removed. "No mechanical restraint is used and no patients are secluded except on order of a physician." The system is described as a "decided success," with patients being "more contented" and the hospital more sanitary, as patients had access to toilet facilities at all times. Under the new system, the report stated, escapes were unknown.
Efforts were also made to find "suitable employment" on the farm or in the garden, lawns, sewing room, kitchen and laundry for all patients able to work. "Efforts to re-educate the chronic insane, are of great importance, both to the patient and the institution," the report said.
The lawn, at that time, included flowers, shrubbery, a fountain and a small greenhouse, all of which were cared for by the patients. The farm consisted of 15 acres of woodland, used for raising and fattening hogs, three acres of poultry yards and 20 acres used for truck gardening. The remaining land was used for grazing purposes and supported a fine dairy herd. The garden produced enough to feed patients and staff during the summer, with some carryover into winter vegetables and canned goods. During the 1908-09 fiscal year, patients and staff canned 35,000 gallons of tomatos, 1,000 gallons of green beans and made 25 barrels of sauerkraut. A total of $8,327.61 in produce, including meat, was grown on the farm.
Included in the report are a list of recommendations for improvement of the facility. Among them is the statement "the criminally insane ought not to be associated with the other insane. A properly constructed ward at the penitentiary should care for this class. The ordinary hospital is not constructed or equipped to care for this type of patients." A second recommendation reads "the insanity laws relating to admissions and discharges should receive the attention of the legislature. In many ways the present laws are defective." Both of these issues were to become a source of state- wide controversy some 60 years later.
While citizens of Spencer welcomed the arrival of the facility for the increased prosperity it brought to the town, there was little interaction between members of the community and residents of the facility. These two groups would remain apart for 70 years until they were at last united by a threat to their combined existence. The "open door" system may have been successful within the institution, but a fence was erected around the grounds to bar patients from the town.
Sometime in the early 1920's the name of the institution was changed to Spencer State Hospital. In 1935, the legislature appropriated $5,000 for a new water filtration system and in 1937 a five-bed hospital clinic was added.
By 1934, annual reports indicate some 7,699 patients had passed through the doors of the hospital and by 1941, 9,165 persons had been treated there. Some never left. Those without family who passed their lives in the institution were buried in unmarked graves on a hillside near the present location of the Spencer Primary Center.
Sometime during the years the nature of the institution changed. Progressive individual treatment provided in a restful pastoral environment gave way to overcrowded and under-staffed conditions, making actual treatment of mental patients impossible. Many residents of the facility were not mentally ill, but simply had nowhere else to go. Among them were elderly persons and unwanted children. In 1950 the hospital's population stood at 1,200. These patients were cared for by three doctors and 150 psychiatric aides. At this time a new treatment for mental illness was implemented at the facility.
In an interview published October 22, 1980 in the Charleston Gazette, Dr. Thomas C. Knapp, superintendent of the hospital when the first frontal lobotomies were performed there, recounted the events of what he called "a grim time for our profession."
Dr. James C. Freeman, known as the father of lobotomies in America, just "dropped in" to Spencer State Hospital "without prior announcement," Knapp recalled. "He was a big name in neurology and he had all the proper papers and signatures-all I could do was watch. It was a real grisly thing."
Frontal lobotomies were performed by inserting a two- pronged device under a patient's eyelids and, with a sharp blow, driving it into the brain.
Knapp recalled that Freeman forgot the surgical hammer he used to pound the spikes into the brain. "We finally found a wooden mallet in the kitchen and that's what he used," said Knapp. "I was never convinced that the operation was helpful and it appeared to me we were dealing with a sadistic bastard."
The purpose of performing a lobotomy was to sever the nerve tracks from the frontal lobe of the brain, where ideas originate, and the mid-brain, the seat of the emotions, Knapp explained. It did not really cure a patient's psychosis. It only cut off his reactions to thoughts so he wasn't bothered by them. Lobotomized patients, Knapp said, became apathetic zombies because the they had no emotional feelings. If a long-term follow-up were done, he concluded, the number who actually improved would be practically zero.
Yet an ordinary blue looseleaf notebook, recently surrendered by the hospital to the archives of the W. Va. Department of Culture and History, contains photographic records of nearly 200 Spencer State Hospital patients Freeman operated on between 1949 and 1952. Photos show each patient before, during and after the surgery.
"One of the patients died," Knapp remembered. The autopsy revealed that an abnormally placed artery was severed ruing the surgery, resulting in death by inter-cranial hemorrhage. In the end, Knapp said Freeman "butchered a lot of patients who could have been helped when psychotic drugs came out."
Although they would, in turn, be criticized as inhumane some 20 years later, these new tranquillizers were considered a milestone of progress in the treatment of the menially ill. According to Knapp, they worked like a chemical lobotomy. They did not cure mental illness, but the drugs kept the patients calm, enabling a small number of employees to care for a large population.
The number of employees at the hospital increased during the 1950's to include an administrative assistant to the superintendent, a social worker to direct a newly created department, a dietician, a psychologist, a psychiatrist, a registered nurse, a dietician and a beautician. A hospital library, the first and largest in a state institution, was built along with a new laundry and women's dormitory. An electro- encephalograph for the diagnosis of organic brain disease was added to the hospital's equipment. An 85-bed clinic building was constructed in 1952.
Until 1959, aides at the hospital worked 12 hours a day, six days a week. They were paid $90 a month, from which a $50 maintenance fee for room, board and uniforms was deducted, whether the employee lived on or off the grounds. In that year their hours were reduced to eight per day, the maintenance deduction was abolished and training programs for workers were initiated.
Despite these signs of progress, Spencer State Hospital's function had now become provision of custodial care rather than serving its patients as a therapeutic treatment center. This situation would prove to be the seed of the facility's eventual destruction. Many policies implemented over the next 30 years attempted to free the institution to fulfill a treatment mission again. None would prove successful.