By Robert Murphy – LibertyChat.com contributor –
In the debate over the Affordable Care Act (aka the ACA aka “ObamaCare”), one of the undercurrents is the claim that critics are being “paranoid” for bringing up things like “death panels” (prompting Paul Krugman to use the term as a laugh line). On the contrary, the people who don’t see any danger in giving the government life-and-death power in the health care sector are being quite naive. The threat isn’t merely hypothetical, either. Here I’ll review two shocking episodes of U.S. (and Canadian) 20th century history, to show what can happen when doctors from the government decide you have an unhealthy mind, and the gruesome steps they are willing to take to “fix” it.
Is This a New Saw Movie? Nope, Actual State Mental Hospitals
As I alluded to in a previous post, for a period the condition of U.S. state “mental hospitals” (itself a scary term) was truly horrifying. Americans learned of the shocking situation in an infamous 1946 Life magazine article by Albert Maisel entitled “Bedlam 1946.” A photo gallery with explanatory text is here, while the full article is reprinted here at a PBS site (with a few typos), which should assure the skeptical reader that this is legitimate story.
For our purposes in this post, let me grab some of the more shocking excerpts from Maisel’s article, interspersed with photos from the article (though not necessarily placed in the same location as they appeared in the original article):
In Philadelphia the sovereign Commonwealth of Pennsylvania maintains a dilapidated, overcrowded, undermanned mental “hospital” known as the “Dungeon,” one can still read, after nine years, the five-word legend, “George was killed here, 1937.”
This pitiful memorial might apply quite as well to hundreds of other Georges in mental institutions in almost every state in the Union, for Pennsylvania is not unique. Through public neglect and legislative penny-pinching, state after state has allowed its institutions for the care and cure of the mentally sick to degenerate into little more than concentration camps on the Belsen pattern.
Court and grand-jury records document scores of deaths of patients following beatings by attendants. Hundreds of instances of abuse, falling just short of manslaughter, are similarly documented. And reliable evidence, from hospital after hospital, indicates that these are but a tiny fraction of the beatings that occur, day after day, only to be covered up by a tacit conspiracy of mutually protective silence and a code that ostracizes employees who “sing too loud.”
Yet beatings and murders are hardly the most significant of the indignities we have heaped upon most of the 400,000 guiltless patient-prisoners of over 180 state metal institutions.
We feed thousands a starvation diet, often dragged further below the low-budget standard by the withdrawal of the best food for the staff dining rooms. We jam-pack men, women and sometimes even children into hundred-year-old firetraps in wards so crowded that the floors cannot be seen between the rickety cots, while thousands more sleep on ticks, on blankets, or on the bare floors. We give them little and shoddy clothing at best. Hundreds — of my own knowledge and sight — spend twenty-four hours a day in stark and filthy nakedness.
Those who are well enough to work slave away in many institutions for 12 hours a day, often without a day’s rest for years on end.…
Charges such as these are far too serious to be based solely upon observations of any single investigator. But there is no need to do so. In addition to my own observations on a dozen hospitals, in addition to court records and the reports of occasional investigating commissions, there is now available for the first time a reliable body of data covering nearly one third of all the state hospitals in 20 states from Washington to Virginia, from Maine to Utah. A by-product of [World War II’s] aggravation of the long-existing personnel shortage, this data represents the collated reports of more than 3,000 conscientious objectors who, under Selective Service, volunteered for assignment as mental hospital attendants. The majority are still in service and, with Selective Service approval, these serious young Methodists, Quakers, Mennonites and Brethren have been filling out questionnaires and writing “narratives” for use in the preparation of instructional material for mental-hospital workers.
One may differ, as I do, with the views that led these young men to take up a difficult and unpopular position against service in the armed forces. But one cannot help but recognize their honesty and sincerity in reporting upon the conditions they found in the hospitals to which they were assigned. Supported as they are by other official data, their reports leave no shadow of doubt as to the need for major reforms in the mental-hospital systems of almost every state.
Consider, for instance, the shocking data on brutality and physical abuse of the patients. One report form a New York State hospital reads as follows:
“… The testimony revealed that these four attendants slapped patients in the face as hard as they could, pummeling in their ribs with fists, some being knocked to the floor and kicked….”
From a state hospital in Iowa comes the following report:
“Then the ‘charge’ (attendant) and the patient who had done the choking began to kick the offender, principally along the back, but there were several kicks a the back of the neck and one very painful one in the genitals which caused the victim to scream and roll in agony…. Sometimes more than 20 kicks must have been administered. Finally he was dragged down the floor and locked in a side room. When I asked the ‘charge’ how it started, he said ‘Oh, nothing. That ——- ought to be killed.’ The victim was in handcuffs all the time; had been in handcuffs continuously for several days.”
From an Ohio state hospital:
“An attendant and I were sitting on the porch watching the patients. Somebody came along sweeping and the attendant yelled at a patient to get up off the bench so that the worker-patient could sweep. But the patient did not move. The attendant jumped up with an inch-wide restraining strap and began to beat the patient in the face and on top of the head. ‘Get the hell up…!’ It was a few minutes — a few horrible ones for the patient — before the attendant discovered that he was strapped around the middle to the bench and could not get up.”
Hospital administrators do not, of course, countenance beatings in Connecticut or elsewhere. Yet in case after case, instead of bringing criminal charges, they have been satisfied merely to admonish or, at most, discharge the guilty attendant — leaving him free to move on to other states or even to other hospitals within the same state.…
The investigators of the Connecticut hospitals in 1942 cited the presence of 16 patients in restraint and 32 in seclusion at Norwich State Hospital in February of the year. Deploring this, they expressed the pious hope that “the use of such measures be materially decreased”. Yet in a single month in 1945, according to records cited by two “conchie” attendants, 26 patients in this same hospital spent 6,552 hours in canvas lacings, mittens and sheets. Eighty others spent 13,900 hours in solitary seclusion!
One contentious-objector attendant, reporting from a state hospital in New York, gave the following account of the way in which restraints are abused. He wrote:
“We have one patient, E.E., who has been in restraint sheets for a period of several months; often he is not even toileted once during the day … Another patient, A.H., has been in a camisole for over a month and the only time it is taken off is once a week for bathing.”
In the more “enlightened” hospitals chemical restraints (i.e., drugs) are used to keep the patients under control so that they will be less trouble to the attendant. In theory these drugs can be prescribed only be physicians or registered nurses. In practice they are often sent up to the wards in batches and administered at the discretion of untrained attendants. A case cited by one conchie at another Pennsylvania state hospital (and corroborated by another from the same unit) illustrates the end result of such “free hand” administration of drugs:
“L. was a young man about 25 … so quick and strong that they had a great deal of trouble trying to overpower him. He was given sedation — sodium phenobarbital — every three hours … After a while, after I had objected to the doctor, sedation was stopped and he made a serious attempt to save the boy. I made a copy of his sedation record. In 108 hours he received at least 90 grains [sic] of sodium phenobarbital -making no allowances for probable overdoses and a good bit of Hyoscine. The last few shots were given when he had a fever. He had had so many sedatives, however, that it was hopeless and he died.”
From a New Jersey state hospital, an attendant writes:
“At its worst, which we see daily, the plate takes on the appearance of what usually is found in most garbage cans … I have seen coleslaw salad thrown loose on the table, the patients expected to grab it as animals would … Tables, chairs and floors are … many times covered with the refuse of the previous meal.”
Pennsylvania state law requires that all milk except Grade A be pasteurized. Grade A milk is required to have a bacteria count of fewer than 50,000 per cubic centimeter. On 22 separate occasions from January 1943 to December 1944 tests were made of the milk served in the patients’ dining room at Warren State Hospital. On only six occasions did it comply with the law. The average bacteria count of this unpasteurized raw milk was 398,100. On three occasions it exceeded 1,250,000 and on one occasion it exceeded 3,200,000!
Others [doctors at the state institutions–RPM] however, are incompetents, alcoholics and psychotics who could hold no position in well-run institutions where cure is the objective. All too often the end result can be described in the terms used in a report form an Indiana state hospital:
“During my three months there I never saw the ward doctor give any but a cursory physical examination. He usually would stop but for a moment at the bedside of new patients. He was nicknamed ‘The Butcher’ by the nurses, after his manner of lancing boils. He seldom came to the ward to declare an expired patient dead. He would be called on the phone by the nurse when a patient was thought to have expired. Usually he would say ‘Oke’ and that would be the end of it. On outwards, patients are prepared for and set to the morgue without ever a doctor appearing on the ward.”
From Utah comes the report:
“A patient became ill and his rectal temperature was fond to be 105.4. The doctor who was called replied “He gets a high temperature every once in a while, so don’t worry about it.'”
I’ll stop the excerpting there, but the text (and photos) should convince the casual reader that this was no isolated problem. Furthermore, this wasn’t an example, say, of Japanese or German prisoners of war being mistreated, or of convicted killers receiving bad treatment in prison. No, this was how state-run hospitals dealt with ostensible medical patients in the government’s care. So keep that in mind whenever someone argues that ObamaCare’s critics are being “paranoid.”
Let’s Not Forget the “Ice-Pick” Lobotomies
In case you’re not disgusted enough, let’s explain one of the techniques by which the government dealt with the problem of too many mental patients and not enough funds to deal with them properly. Here I quote (after removing endnotes and hyperlinks) from the Wikipedia article on “Transorbital lobotomy,” also known as an “ice-pick lobotomy” because of the utensil used (see the picture):
The Freeman-Watts prefrontal lobotomy still required drilling holes in the scalp, so surgery had to be performed in an operating room by trained neurosurgeons. Walter Freeman believed this surgery would be unavailable to those he saw as needing it most: patients in state mental hospitals that had no operating rooms, surgeons, or anesthesia and limited budgets. Freeman wanted to simplify the procedure so that it could be carried out by psychiatrists in psychiatric hospitals.
Inspired by the work of Italian psychiatrist Amarro Fiamberti, Freeman at some point conceived of approaching the frontal lobes through the eye sockets instead of through drilled holes in the skull. In 1945 he took an icepick from his own kitchen and began testing the idea on grapefruit and cadavers. This new “transorbital” lobotomy involved lifting the upper eyelid and placing the point of a thin surgical instrument…under the eyelid and against the top of the eyesocket. A mallet was used to drive the orbitoclast through the thin layer of bone and into the brain along the plane of the bridge of the nose, around fifteen degrees toward the interhemispherical fissure. The orbitoclast was malleted five centimeters (2 in) into the frontal lobes, and then pivoted forty degrees at the orbit perforation so the tip cut toward the opposite side of the head (toward the nose). The instrument was returned to the neutral position and sent a further two centimeters (4⁄5 in) into the brain, before being pivoted around twenty-eight degrees each side, to cut outwards and again inwards….
Freeman performed the first transorbital lobotomy on a live patient in 1946. Its simplicity suggested the possibility of carrying it out in mental hospitals lacking the surgical facilities required for the earlier, more complex procedure (Freeman suggesting that, where conventional anesthesia was unavailable, electroconvulsive therapy be used to render the patient unconscious). In 1947, the Freeman and Watts partnership ended, as the latter was disgusted by Freeman’s modification of the lobotomy from a surgical operation into a simple “office” procedure. Between 1940 and 1944, 684 lobotomies were performed in the United States. However, because of the fervent promotion of the technique by Freeman and Watts, those numbers increased sharply towards the end of the decade. In 1949, the peak year for lobotomies in the US, 5,074 procedures were undertaken, and by 1951 over 18,608 individuals had been lobotomized in the US.
Make sure you don’t miss this element of the story: Not only did state mental patients have an “ice pick” jammed into their eyesockets to cut up their brains, but if the facility didn’t want to spend the money on anesthesia, they would first be knocked out with jolts of electricity. And remember, we’re not here describing horrible interrogation techniques deployed on Nazi spies: This is what the government was doing to “help” people with bad “mental hygiene.”
The CIA Connection
But wait, I can make the story even creepier. It’s already a horror movie, let’s turn it into a spy thriller as well. Although she unfortunately tries to use the episode as an indictment of free-market capitalism, Naomi Klein’s journalistic efforts in her book The Shock Doctrine showcase the horrible treatment of psychiatric patients in Canada, in a program that was partly funded by the CIA. Specifically, an American doctor, Ewen Cameron–who had been president of both the American and Canadian Psychiatric Associations–developed a program to utterly destroy a patient’s notion of self, to be replaced with healthier views and habits. Yet to break down the patient, Cameron employed a combination of sensory deprivation, drugs, and electrical shocks. Naturally, the CIA eventually became interested. I’ll quote here just a portion of Klein’s narrative to give a sense of the story:
Cameron had…convinced himself that violent destruction of the minds of his patients was the necessary first step on their journey to mental health and therefore not a violation of the Hippocratic oath. As for consent, his patients were at his mercy; the standard consent form endowed Cameron with absolute power to treat, up to and including performing full frontal lobotomies.
Although he had been in contact with the agency for years, in 1957 Cameron got his first grant from the CIA…And, as the CIA dollars poured in, the Allan Memorial Institute [located in Montreal–RPM] seemed less like a hospital and more like a macabre prison.
The first changes were the dramatically increased dosages of electroshock…Cameron started using the machine on his patients twice a day for thirty days…To the already dizzying array of drugs he was giving his patients, he added more experimental, mind-altering ones that were of particular interest to the CIA: LSD and PCP.
Cameron further starved his patients’ senses in the so-called Sleep Room, where they were kept in drug-induced reverie for twenty to twenty-two hours a day…Patients were kept in this state for fifteen to thirty days, though Cameron reported that “some patients have been treated up to 65 days of continuous sleep.”…To make sure no one successfully escaped from this nightmare, Cameron gave one group of patients small doses of the drug Curare, which induces paralysis, making them literal prisoners in their own bodies…
There are several strong indications that Cameron was well aware he was simulating torture conditions…In an interview with a popular magazine in 1955, he openly compared his patients to POWs facing interrogation, saying that they, “like prisoners of the Communists, tended to resist [treatment] and had to be broken down.” [Naomi Klein, The Shock Doctrine, pp. 35-37]
I realize that allusions to the CIA’s MK-Ultra program might make some readers roll their eyes and say, “Yep, paranoid stuff.” Well, for what it’s worth, the CIA agreed to pay some of the patients who sued in a class-action suit, as is explained matter-of-factly in this Canadian news article on a woman trying to bring a new suit in 2007.
In conclusion, let me point out the big picture here: You absolutely DO NOT want the government–even a “nice” government like in the United States or Canada–getting more control over health care. History shows the things that can happen when people are dependent on the care of socialized medicine. The results can be horrifying.