What She Left Behind (34 page)

While Izzy gave Clara the rest of her photos and the letters to Bruno, Susan asked the nurse about Clara’s health. After a few minutes, she knelt next to Clara.

“Nurse Jennie says you’re fairly healthy,” she said.

“I suppose I am,” Clara said. “Except for being old and stiff and a little forgetful every now and then.”

“Well,” Susan said. “How would you feel about coming to stay with me? I’ve got a big old house not far from here, with a huge garden and two dogs. It’s nothing elaborate, but it’s home.”

Clara’s lips trembled. “I haven’t had a home in sixty-six years,” she said in a small voice.

“Well then,” Susan said. “My home is your home if you’d like it to be. And I’m retired now, so I’ll always be there to watch over you.”

Clara smiled, her eyes glistening. “I would love that more than anything in this world,” she said.

CHAPTER 26

I
ZZY

Hurrying into the kitchen after school on Thursday, Izzy’s mouth watered, picturing Harry’s famous chocolate chip cookies stacked beneath a glass cover on the island counter. She could hardly wait to pour a big glass of milk and gobble up three or four. Harry made the cookies every other week, and she couldn’t remember tasting anything so delicious. She dropped her books on the back door bench, hung up her coat, and stopped dead in her tracks. Somehow, with everything going on over the past two weeks—her mother’s burial, talking to Miss Trench, going on her first date with Ethan, finding Clara and her daughter—she’d forgotten what day it was.

Peg and Harry were standing at the kitchen island, wide smiles stretched across their faces. Instead of cookies, a chocolate cake covered with pink and white roses sat on the counter, eighteen burning candles reflected in Peg’s and Harry’s eyes. Dozens of pink and purple balloons floated near the ceiling, their curling strings like pastel rain. Peg and Harry started singing “Happy Birthday” and Izzy choked back tears. She couldn’t remember the last time anyone had thrown her a party, let alone sang “Happy Birthday” to her. How ironic that this was the birthday she’d been dreading.

“Make a wish!” Peg said.

“Okay,” Izzy said, her face flushing. She held back her hair and blew out the candles.

“I told Peg we should wait until after dinner to sing to you,” Harry said. “But she couldn’t wait. She wanted to surprise you.”

“Thank you,” Izzy said. “You didn’t have to get a cake for me.”

“Yes we did!” Peg said. She hurried around the island and gave Izzy a hug. “And we have more surprises too.” She went to the table and pulled out a chair. “But first, can you sit down so we can talk about something?”

Izzy sat down, her heartbeat picking up speed. Peg folded her hands on the kitchen table, took a deep breath and let it out slowly. She cleared her throat and swallowed, as if she didn’t know where to begin. An icy coil of sadness twisted in Izzy’s chest.
Here we go,
she thought.
She’s going to tell me it’s time to leave because they can’t afford to keep me here. She’s going to apologize and say they wanted to give me a birthday party so I’d have something to remember them by.

“I know it’s probably too soon after your mother’s passing,” Peg said. “But Harry and I have been talking about it for a while now. We’ve already got the papers in order, and . . . well . . . it’s up to you . . . but . . .” She looked at Harry for reinforcement. Harry came around the kitchen island, wiping his hands on his pants.

“We realize you’re an adult as of today,” he said. “So you might not think this is a good idea. But we . . .” He sat down and took Peg’s hand. “We’d like to adopt you, Izzy. We know you probably think you don’t need . . . what I’m trying to say is, we’d really like to be your parents.”

Izzy’s mouth dropped open. Words escaped her. Peg took her hands in hers.

“We love you and want to be here for you,” Peg said, her voice shaking. “You’ve still got a lot of decisions to make in your life, decisions that are too hard to make alone. We’d like to help you, and see you go to college to find your full potential, whatever that may be. And when you get married . . .” Peg’s eyes brimmed with tears and she squeezed Izzy’s hand. “Harry would be honored to walk you down the aisle. And we would love to be grandparents someday.”

Izzy pressed her lips together, her chin trembling. She opened her mouth to say yes, to tell them she’d love to be their daughter more than anything in the world, but her throat closed.

“What do you say, kiddo?” Harry said.

Izzy nodded, smiling. Peg squealed and put her hands over her mouth. They all stood and hugged each other. Izzy closed her flooding eyes, wondering how it was possible that her heart could be bursting with so much joy after being filled with so much sorrow. She hugged Peg and Harry tighter, letting their strong arms chase away her worries and fears.

“You’ve made us so happy,” Peg said, sniffing.

Just then, someone knocked on the kitchen door. “Come on in!” Harry said.

Alex and Ethan entered the room, their arms laden with presents. “Happy Birthday!” they said at the same time. Behind them, Clara and Susan entered arm in arm, both of them beaming.

During the writing of
What She Left Behind,
I relied on the following books:
The Lives They Left Behind: Suitcases from a State Hospital Attic,
by Darby Penney and Peter Stastny;
Ten Days in a Mad-House,
by Nellie Bly; and
Women of the Asylum: Voices from Behind the Walls 1840–1945,
by Jeffery L. Geller and Maxine Harris.

Although the above books helped a great deal in imagining what conditions must have been like inside insane asylums, my novel is not a historical work and has no intention of being one. It is my interpretation of what it might have been like to be committed against one’s will. The characters in this novel are entirely fictitious. But several of the places described, including the Long Island Home and Willard State, are real. Chapin Hall, and its attached wards and outbuildings, existed. At Willard there were also detached patient wards: the Pines, the Maples, Sunnycroft, and the Edgemere, each with its own dining room, kitchen, supervisor’s office, apartments, and boiler house. It is also important to note that for purpose of plot, patient treatments and therapies were portrayed as being in use either earlier or later than was actually the case. The Utica Crib, a locked wooden cage, was put out of use in 1887. Insulin shock therapy was put into use in 1935. Electroshock therapy was put into use in 1938. And, finally, psychologists were not used in most state asylums until 1960.

Please turn the page
for a very special Q&A
with Ellen Marie Wiseman!

 

 

 

 

I’ve always been curious about insane asylums, especially the way patients were treated for mental illness in the past, and how our understanding and treatment has evolved over the years. I’ve often wondered what it would be like to be committed to an institution and kept against my will. When I read about the Willard Suitcase Exhibit, a collection of patient suitcases found in the attic of the shuttered Willard asylum, I was immediately intrigued. That’s how I learned about
The Lives They Left Behind: Suitcases from a State Hospital Attic
, by Darby Penney and Peter Stastny. The authors’ mission was to examine the contents of the luggage in an attempt to re-create the lives of those patients who had checked into the institution but never checked out. The book is fascinating and haunting because the pictures and stories are so easy to identify with. After reading it, I knew I wanted to write about finding the suitcases, and what it might have been like being a patient.

 

 

It was difficult reading about people in the past being institutionalized, in many cases for the rest of their lives, because of emotional or economic distress. While some patients were truly ill, many were sent to asylums under circumstances we view differently today: poverty, homelessness, depression, homosexuality, alcoholism, and emotional distress due to divorce, family disputes, abusive relationships, and the loss of children. A person could be committed for something as simple as being unable to find work, or for a single angry public outburst. In the late 1800s, Dr. Judson B. Andrews wrote a paper entitled
Early Indications of Insanity
—suggesting families take note of “morbid dreams, sleep impairments, constant headaches, emotional exaggerations, excessive religious scruples, and changes in habits of dress and cleanliness.”

Women were especially vulnerable to being institutionalized for the long term. Husbands could commit their “troublesome” wives, while male doctors were more than willing to oblige. Many women also worked as domestics and were in close contact with their employers ; any bad behavior or dispute could be contrived as mental illness. By the end of its first year of operation, Willard housed four times as many women as men. In one case, a woman sent to Willard because of depression spent the remaining seventy-five years of her life there, until she died at the age of one hundred and one. Immigrants with few community connections were sometimes sent to asylums while their families in the old country had no idea where they were. Many “mad” patients were sent to public asylums from other state hospitals, arriving in groups of a hundred or more, crammed into trains or buses, unaware of where they were being taken. Nearly half of the 54,000 individuals who entered Willard died there.

 

 

What surprised me the most was that forced sterilization was a common practice in state mental hospitals from about 1910 to the end of WWII, when it was largely stopped because of embarrassing comparisons to Nazi policies. In some southern states it continued into the 1960s. This led to my discovery that the United States was the first country to concertedly undertake compulsory sterilization programs for the purpose of eugenics (a science that deals with the improvement of hereditary qualities of a race or breed, usually through selective breeding and sterilization), the principle targets being the mentally ill. Between 1907 and 1963, over 64,000 individuals (including others who were not mentally ill) were forcibly sterilized under eugenic legislation in the United States. According to Edwin Black, award-winning author of
War Against the Weak: Eugenics and America’s Campaign to Create a Master Race,
one method commonly suggested to get rid of “inferior” populations was euthanasia. A 1911 Carnegie Institute report mentioned euthanasia as one of its recommended “solutions” to the problem of cleansing society of unfit genetic attributes. The most commonly suggested method was to set up local gas chambers. However, many in the eugenics movement did not believe that Americans were ready to implement a large-scale euthanasia program, so many doctors had to find clever ways of subtly implementing eugenic euthanasia in various medical institutions. For example, one mental institution fed its incoming patients milk infected with tuberculosis (reasoning that genetically fit individuals would be resistant), resulting in 30 to 40 percent annual death rates. Other doctors practiced eugenicide through various forms of lethal neglect.

 

 

Because psychotropic drugs weren’t discovered until the mid-1950s, the only drugs available to treat patients were sedatives. Patients with psychiatric symptoms as a result of syphilis were treated with arsenic and infected with malaria! At Willard, psychologists weren’t available until the 1960s, and patients rarely met with a medical doctor. According to Darby Penney, coauthor of
The Lives They Left Behind,
some patients were not seen by a doctor for decades. In the 1930s, the time period of Clara’s story, treatment included ice baths, arts and crafts, and exercise. Years later, treatment also included insulin therapy and electroshock therapy. In my research I found no evidence that lobotomies were performed at Willard. Able-bodied patients who were not dangerous or actively delusional were required to work, which was considered therapeutic.

 

 

Like most state-run mental institutions, Willard was dependent on unpaid patient labor to sustain its operation. Willard had over six hundred acres of farmland, a greenhouse, a dairy, stables, chicken houses, piggeries, and barns where nearly all the facility’s food was raised and processed. Industrial shops produced clothing, shoes, brooms, baskets, soap, and caskets. There were laundries, bakeries, kitchens, a slaughterhouse, woodworking shops, brickworks, a blacksmith’s shop, and a coal-fired power plant whose boilers were fed by patients hauling coal by wheelbarrows from the hospital’s rail yard. The facilities were overseen by paid labor but most of the work was done by patients, who worked on the grounds crews, excavated for new construction, cleaned the wards and offices, served the food, and staffed the luxurious home of the superintendent.

 

 

The biggest difference was the duel timeline. I basically had to write two stories and blend them together in a way that worked. It was harder than I thought!

 

 

Yes, in the case of Christine (of
The Plum Tree
) and Clara, both are young women being denied a normal life during a time of great social change. Christine suffered as a result of poor economic times, war, and her government’s intolerance of certain individuals. Clara suffered because of the stock market crash, her father’s and society’s expectations of women, and, once she was labeled mentally ill, also because of her government’s intolerance of certain individuals. It’s very likely that, before Clara was sent away, she, like Christine, saw posters advocating for the “removal” of certain individuals deemed unfit for society. A 1926 U.S. Eugenics poster claimed “Some people are born to be a burden on the rest,” and reminded people that every sixteen seconds a person is born and one hundred dollars of their money goes toward the care of persons with bad heredity, such as the insane, feeble-minded, criminals, and other defectives. Both women were forbidden to marry the man they loved, Isaac because he was Jewish, and Bruno because he was a poor immigrant. Both rebelled against doing what they were told, Christine against the Gestapo, and Clara against her father and the doctors at Willard. Both endured terrible hardship at the hands of institutional captors who showed little regard for human dignity, Christine in Dachau, and Clara in Willard. Both women refused to give up hope, and did whatever they could to improve their situations.