A Mind That Found Itself: An Autobiography. Clifford Whittingham Beers

same spirit of economy and commercialism pervaded the entire institution. Its worst manifestation was in the employment of the meanest type of attendant—men willing to work for the paltry wage of eighteen dollars a month. Very seldom did competent attendants consent to work there, and then usually because of a scarcity of profitable employment elsewhere. Providentially for me, such an attendant came upon the scene. This young man, so long as he remained in the good graces of the owner-superintendent, was admittedly one of the best attendants he had ever had. Yet aside from a five-dollar bill which a relative had sent me at Christmas and which I had refused to accept because of my belief that it, like my relatives, was counterfeit—aside from that bill, which was turned over to the attendant by my brother, he received no additional pecuniary rewards. His chief reward lay in his consciousness of the fact that he was protecting me against injustices which surely would have been visited upon me had he quitted his position and left me to the mercies of the owner and his ignorant assistants. To-day, with deep appreciation, I contrast the treatment I received at his hands with that which I suffered during the three weeks preceding his appearance on the scene. During that period, no fewer than seven attendants contributed to my misery. Though some of them were perhaps decent enough fellows outside a sickroom, not one had the right to minister to a patient in my condition.

      The two who were first put in charge of me did not strike me with their fists or even threaten to do so; but their unconscious lack of consideration for my comfort and peace of mind was torture. They were typical eighteen-dollar-a-month attendants. Another of the same sort, on one occasion, cursed me with a degree of brutality which I prefer not to recall, much less record. And a few days later the climax was appropriately capped when still another attendant perpetrated an outrage which a sane man would have resented to the point of homicide. He was a man of the coarsest type. His hands would have done credit to a longshoreman—fingers knotted and nearly twice the normal size. Because I refused to obey a peremptory command, and this at a time when I habitually refused even on pain of imagined torture to obey or to speak, this brute not only cursed me with abandon, he deliberately spat upon me. I was a mental incompetent, but like many others in a similar position I was both by antecedents and by training a gentleman. Vitriol could not have seared my flesh more deeply than the venom of this human viper stung my soul! Yet, as I was rendered speechless by delusions, I could offer not so much as a word of protest. I trust that it is not now too late, however, to protest in behalf of the thousands of outraged patients in private and state hospitals whose mute submission to such indignities has never been recorded.

      Of the readiness of an unscrupulous owner to employ inferior attendants, I shall offer a striking illustration. The capable attendant who acted as my protector at this sanatorium has given me an affidavit embodying certain facts which, of course, I could not have known at the time of their occurrence. The gist of this sworn statement is as follows: One day a man—seemingly a tramp—approached the main building of the sanatorium and inquired for the owner. He soon found him, talked with him a few minutes, and an hour or so later he was sitting at the bedside of an old and infirm man. This aged patient had recently been committed to the institution by relatives who had labored under the common delusion that the payment of a considerable sum of money each week would insure kindly treatment. When this tramp-attendant first appeared, all his visible worldly possessions were contained in a small bundle which he carried under his arm. So filthy were his person and his clothes that he received a compulsory bath and another suit before being assigned to duty. He then began to earn his four dollars and fifty cents a week by sitting several hours a day in the room with the aged man, sick unto death. My informant soon engaged him in conversation. What did he learn? First, that the uncouth stranger had never before so much as crossed the threshold of a hospital. His last job had been as a member of a section-gang on a railroad. From the roadbed of a railway to the bedside of a man about to die was indeed a change which might have taxed the adaptability of a more versatile being. But coarse as he was, this unkempt novice did not abuse his charge—except in so far as his inability to interpret or anticipate wants contributed to the sick man's distress. My own attendant, realizing that the patient was suffering for the want of skilled attention, spent a part of his time in this unhappy room, which was but across the hall from my own. The end soon came.

      My attendant, who had had training as a nurse, detected the unmistakable signs of impending death. He forthwith informed the owner of the sanatorium that the patient was in a dying condition, and urged him (a doctor) to go at once to the bedside. The doctor refused to comply with the request on the plea that he was at the time "too busy." When at last he did visit the room, the patient was dead. Then came the supervisor, who took charge of the body. As it was being carried from the room the supervisor, the "handy man" of the owner, said: "There goes the best paying patient the institution had; the doctor" (meaning the owner) "was getting eighty-five dollars a week out of him." Of this sum not more than twenty dollars at most, at the time this happened, could be considered as "cost of maintenance." The remaining sixty-five dollars went into the pocket of the owner. Had the man lived for one year, the owner might have pocketed (so far as this one case was concerned) the neat but wicked profit of thirty-three hundred and eighty dollars. And what would the patient have received? The same privilege of living in neglect and dying neglected.

VIII

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      For the first few weeks after my arrival at the sanatorium, I was cared for by two attendants, one by day and one by night. I was still helpless, being unable to put my feet out of bed, much less upon the floor, and it was necessary that I be continually watched lest an impulse to walk should seize me. After a month or six weeks, however, I grew stronger, and from that time only one person was assigned to care for me. He was with me all day, and slept at night in the same room.

      The earliest possible dismissal of one of my two attendants was expedient for the family purse; but such are the deficiencies in the prevailing treatment of the insane that relief in one direction often occasions evil in another. No sooner was the expense thus reduced than I was subjected to a detestable form of restraint which amounted to torture. To guard me at night while the remaining attendant slept, my hands were imprisoned in what is known as a "muff." A muff, innocent enough to the eyes of those who have never worn one, is in reality a relic of the Inquisition. It is an instrument of restraint which has been in use for centuries and even in many of our public and private institutions is still in use. The muff I wore was made of canvas, and differed in construction from a muff designed for the hands of fashion only in the inner partition, also of canvas, which separated my hands, but allowed them to overlap. At either end was a strap which buckled tightly around the wrist and was locked.

      The assistant physician, when he announced to me that I was to be subjected at night to this restraint, broke the news gently—so gently that I did not then know, nor did I guess for several months, why this thing was done to me. And thus it was that I drew deductions of my own which added not a little to my torture.

      The gas jet in my room was situated at a distance, and stronger light was needed to find the keyholes and lock the muff when adjusted. Hence, an attendant was standing by with a lighted candle. Seating himself on the side of the bed, the physician said: "You won't try again to do what you did in New Haven, will you?" Now one may have done many things in a city where he has lived for a score of years, and it is not surprising that I failed to catch the meaning of the doctor's question. It was only after months of secret puzzling that I at last did discover his reference to my attempted suicide. But now the burning candle in the hands of the attendant, and a certain similarity between the doctor's name and the name of a man whose trial for arson I once attended out of idle curiosity, led me to imagine that in some way I had been connected with that crime. For months I firmly believed I stood charged as an accomplice.

      The putting on of the muff was the most humiliating incident of my life. The shaving of my legs and the wearing of the court-plaster brand of infamy had been humiliating, but those experiences had not overwhelmed my very heart as did this bitter ordeal. I resisted weakly, and, after the muff was adjusted and locked, for the first time since my mental collapse I wept. And I remember distinctly why I wept. The key that locked the muff unlocked in imagination the door of the home in New