Vars, Fredrick E.

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Alabama Law Scholarly Commons Articles Faculty Scholarship 2011 Subversive Apologia Symposium: The Right to Treatment and the Road Ahead Fredrick E. Vars University of Alabama - School of Law, fvars@law.ua.edu Follow this and additional works at: https://scholarship.law.ua.edu/fac_articles Recommended Citation Fredrick E. Vars, Subversive Apologia Symposium: The Right to Treatment and the Road Ahead, 35 Law & Psychol. Rev. 109 (2011). Available at: https://scholarship.law.ua.edu/fac_articles/313 This Article is brought to you for free and open access by the Faculty Scholarship at Alabama Law Scholarly Commons. It has been accepted for inclusion in Articles by an authorized administrator of Alabama Law Scholarly Commons. SUBVERSIVE APOLOGIAFredrick E. Vars*The mentally ill have been described as "a historically voicelessgroup."' History is more complicated than that. To be sure, it is hard toidentify a more marginalized group of individuals, but sometimes theirvoices have rung out. One place they did was an underappreciated publica-tion at one of the nation's oldest and largest in-patient psychiatric facili-ties.The Bryce News: Of the Patients, By the Patients, For the Patientswas a weekly newsletter produced, as the subtitle states, by the patients ofBryce Hospital. The first issue came out May 17, 1951, and the last, July17, 1972. I estimate a circulation of 476 copies per week around the mid-dle of its run, which at least occasionally included copies sent to outsidenewspapers and others.2 In this short essay, I review several dozen issuesof the newsletter. The Bryce News contained surprisingly direct criticismof the institution, or at least those funding it. This may have in part re-flected common concerns of patients and caregivers. On the other hand,there was apparently a heavy dose of institutional pressure to discouragelitigation and encourage adherence to rules. But the great legacy of TheBryce News is the light it sheds on life as a patient. This essay is in part anintroduction to the examples that follow of patient self-expression takendirectly from the newsletter.The Bryce News was founded by a patient, Sara Mayfield, and the di-rector of the recreation program, Virginia Dobbins, shortly after she tookover that position. 3 True to that genesis, much of each (initially 4-page)issue was devoted to descriptions of recreational activities. Therefore, it isnot surprising that the second issue included a long summary of recrea-tional opportunities available at Bryce in 1880:* Associate Professor, University of Alabama School of Law. Thanks to Heather Elliott, Caro-line Harada, Steven Hobbs, and James Leonard for helpful comments on earlier drafts. MichaelReeves provided excellent research assistance.1. Cara H. Drinan, The National Right To Counsel Act: A Congressional Solution to the Nation'sIndigent Defense Crisis, 47 HARV. J. ON LEGIS. 487, 517 (2010).2. The Bryce News: Of the Patients, By the Patients, For the Patients, Vol. I 1-No. 18, at 4(July 29, 1961) [hereinafter referred to by Volume and Issue Number only]. Cf. Vol. 5-No. 1, at 1(Mar. 26, 1955) ("615 copies are printed each week").3. Vol. 1-No. 9, at 1 (May 17, 1951); Vol. 21-No. 1, at 1 (Mar. 26, 1971).Law & Psychology ReviewThe usual routine of games and pastimes, so often described in myreports, is still scrupulously observed. Billiards, tenpins, draughts,cards, croquet, table games of every sort, evening walks in thegarden, musical entertainments, theatrical exhibitions, dances,readings and recitations, and lectures, etc., are still popular expe-dients for enlivening the tedium of hospital life.4This quotation from the 1880s was followed by an "[elditor's com-ment: [iut seems we were born a hundred years too late. I wonder if moon-light was provided for 'evening walks in the garden'."' This is an earlyglimpse of the patient's perspective, which would continue to appear in thenewsletter. Had it been directed solely at recreation, The Bryce Newscould hardly be called subversive. But it was from the outset about muchmore than recreation. That second issue also included the following bitingcartoon about the inefficacy of lawyers: 6.A~~i 4 1 Iti wf.A a.tfl- #o~ci1Zht will- I'l C, z 1 U..4. Vol. 1-No. 2, at 1 (Mar. 29, 1951) (quoting Mr. John Bradford, Bookkeeper of Bryce,describing Dr. Bryce's 1880 annual report).5. Id.6. Vol. 1-No. 2, at 2 (Mar. 29, 1951).110 [Vol. 35Subversive ApologiaThe third issue broadened the critique from lawyers to fundamentalpolicy:Wisconsin ranks highest in appropriation per patient per day with$3.84. Tennessee with lowest at $1.07. Alabama with $1.29 perday is far below the average of $2.04 over the nation as a whole.Alabama owes it to her mentally ill to bring her appropriation tothe nation's average or much nearer than the present.Ratio of personnel to patients:1 Physician to 535 patients1 Graduate Nurse to 611 [patients]1 Attendant to 10 patients1 Psychologist to 2,140 [patients]1 Occupational Therapist to 1,070 patients.The Bryce Hospital is the most over-crowded state hospital in thenation with 109% over its rated capacity of 2,048 with 4,279 pa-tients as of January 1, 1950. This condition is even worse todaywith 4,526 patients and no new buildings to care for the increase.We take our hats off to the present staff for the improvements de-rived out of the recent increase of $1.00 per patient, weekly but,this only amounts to 4[cents] per day per patient, which totals$1.43 per day.7Note how the criticism has moved from addendum to center stage.The add-on this time is a nod to the staff who, the author suggests, madethe most of the little they received.Why was such criticism allowed? One easy answer is that it actuallyserved the interests of the Bryce administrators and staff. The director ofrecreation would have loved more support for recreation. The hospitalgenerally would have loved a bigger budget. This is certainly part of theanswer. In 1955, the Superintendent of Bryce himself stated in the new-sletter that "treatment and living conditions are not what is desired."' Thenewsletter existed at the mercy of the hospital (although apparently with-out its financial support).9 But the interests of the patients and the adminis-7. Vol. 1-No. 3, at 1 (Apr. 6, 1951).8. Vol. 5-State Fair Ed., at 2 (Oct. 1955).9. Vol. 1-No. 1, at 4 (Mar. 22, 1951) (setting forth subscription rates and stating that "[ilnorder for the newspaper to continue, it is necessary for this publication to become self-supporting").2011] 111Law & Psychology Reviewtrators were not always aligned, and sometimes the patients writing for thenewsletter managed to serve two masters.The following early story from the newsletter is arguably an illustra-tion of this phenomenon:POSTAL VIOLATION RUMOR SPIKEDPersistent rumors are circulated among the patients in regard tothe way in which the hospital handles their incoming and outgoingmail. Last week one of our inquiring reporters asked about thesethings at the Post Office. According to the postal regulations it ispermissible for the hospital authorities to open both incoming andoutgoing mail, even sealed and stamped letters sent by the patientsto their relatives.10On its face, this story debunks the rumor that the hospital was violat-ing postal regulations, which obviously served the -administrators' inter-ests. But the story also stands as a notice to patients that all of their mailcould be read by the hospital. Notably, a right of privacy in postal com-munications was part of the patients' bill of rights established by the courtin Wyatt."I do not want to overstate the subversiveness of the newsletter. A longstory in another early issue was devoted to the futility of pursuing habeascorpus: "the difficulties involved make habeas corpus no more that [sic] awill of the wisp, the false light dancing in the swamp which lures the un-wary to destruction, therefore better forgotten than begun."1 2 Good beha-vior was the path to freedom, not the law, according to this article thatexpressly denies being "hospital propaganda."13 Disclaimer notwithstand-ing, it seems the hospital held the upper hand and more often than not gotits message across.But the patients' voice sometimes rang clear, and was heard. The June22, 1951 issue included a piece titled, "DANGER OVERHEAD," rerunthe next week with a postscript:In our June 22nd issue the following appeared:"The plastering on Ward 8 East has fallen recently threetimes. Once a patient was injured; once by a divine mercy it10. Vol. 1-No. 8, at 1 (May 11, 1951).11. Wyatt v. Stickney, 344 F. Supp. 373, 379-80 (M.D. Ala. 1972).12. Vol. 1-No. 10, at 1 (May 25, 1951).13. Id. at 1, 4; see also Vol. 1-No. 4, at 2 (Apr. 13, 1951) ("So let's think before we violateany rule or regulation handed down to us by the staff and remember they have our interest, individual-ly and collectively at heart.").112 [Vol. 35Subversive Apologiafell during the day in a room occupied at night; and once dur-ing the day in a hall in which we walk. The situation has beenreported by our ward attendant a number of times. Nothinghas been done. WE ARE FRIGHTENED!["]Nothing has yet been done.THE NEWS can add no force to the above appeal. It can and willrun the appeal issue by issue until the situation is corrected.14The next week's issue reported that repairs were being made. 15More than falling plaster was apparently repaired. One former patientin 1964 wrote that as compared with ten years earlier conditions "are somuch improved it would take pages and pages to describe them." 1 6 Its co-founder, at least, would no doubt have attributed some of that progress tothe newsletter.17Perhaps the most compelling patient complaint was lodged by Geral-dine M. Chafin in the March 17, 1972 issue. She described the difficultiesfaced by Bryce patients in obtaining employment, both before and afterrelease.' 8 She relayed her own experience qualifying for a federal clerk-typist position, but beingturned down for employment for "Physical Requirement" - beingin Bryce Hospital. I type this paper. I am in perfect physical andmental health, yet I have spent the better part of 16 years in BryceHospital with my life ruined.Some patients' families are ashamed of us because we are fromBryce Hospital. Our families can call police and have us put in jailand brought to Bryce Hospital without ever seeing a doctor. Thenthey will not get us out of the hospital.It is time for an awakening by the public of the injustice of keep-ing able-bodied, well people in mental institutions because of14. Vol. 1-No. 15, at 2 (June 29, 1951).15. Vol. 1-No. 16, at 4 (July 6, 1951).16. Vol. 14-No.4, at 2 (Apr. 11, 1964).17. Vol. 5-No. 7, at 1 (May 7, 1955) (attributing upsurge of interest and desire to help to thewide distribution of The Bryce News).18. See Vol. 22.2011] 113Law & Psychology Reviewfamily prejudices. . . . Our opportunities are hampered, but westill have hope.' 9Ms. Chafin's plea was directed well beyond Bryce and was heard at ahigh level. Two weeks later, The Bryce News published a response fromthe Alabama Commissioner of Mental Health, Stonewall B. Stickney,praising Ms. Chafin's clarity and honesty. 2 0However subversive (or not) The Bryce News may have been at its in-ception, it may have become intolerably so near its demise. It is one thingto report doctor-patient ratios in a 1951 appeal for more funding. It wouldhave been quite another to provide plaintiffs' attorneys with complianceinformation after the court orders in Wyatt. For example, one order inWyatt required 2 psychiatrists and 4 medical doctors for every 250 pa-tients,21 as compared with the 1 physician to 535 patients ratio reported in1951 .22 The Bryce News published its last issue mid-volume 3 months afterthat order.23 Attorneys for the state during Wyatt no doubt wanted controlover which patients were saying what.To conclude, three themes emerge from this brief review of The BryceNews (and the examples that follow): (1) a perhaps unexpected symbiosisbetween patient and caregiver in identifying problems at Bryce and press-ing for solutions; (2) remarkable cogency and clarity of expression amongindividuals deemed too mentally unfit for life in the community; and (3) asometimes ambivalent fixation on the conditions of confinement and free-dom.EXAMPLES AND ILLUSTRATIONSDuring its run, The Bryce News provided an outlet for patient self-expression in poetry, cartoons, and jokes. Here are some examples thatillustrate both the humanity of the patients and how much can be con-veyed, even under a censor's watchful eye:I WAS MYSELFby Harry R. LondonI am myself - not yet, but shall be;19. Vol. 22-No. 1, at 1, 3 (Mar. 17, 1972).20. Vol. 22-No. 3, at 1 (Apr. 14, 1972).21. Wyatt v. Stickney, 344 F. Supp. 373, 383 (M. D. Ala. 1972).22. See supra note 7 and accompanying text.23. That last issue's banner headline was: "FIRST PAYROLL ISSUED." Vol. 22-No. 9, at 1(July 17, 1972). The story explained that as a result of the Wyatt case, patient-workers received theirfirst paychecks. Id. Before that, they received only "notice" and "a great big salute." Vol. 14-No.51, at 3 (Mar. 12, 1965).114 [Vol. 35Subversive ApologiaLess than I become, more than I do;Equal to my friends; less than my love;More than my work, -less than my poetry;Making and unmaking myself - man;Rebuked and doubted and the between,And hide myself and give myself away;And say less than I think, more than I mean.I built a house which I may not inhabit,And sow a vineyard which I may not reap,And ponder with problems which are not my own,And read a language I may never speak-And joke and err and plan to be forgiven.I am all these I do; like many, haveOffenses more than thoughts; but no helpers,Except the words I cast into the mails.24The poetry was interspersed with humorous, but telling, thoughts andconversations of the patients:Patient to Doctor: "Can I go home in a few more days?"Doctor to Patient: "Do you think your wife will let you stay?"Patient to Doctor: "Sure. She said she would put me in the gar-den. It has a real strong fence."F.E.B. - - Ward 33.2524. Vol. 1-No. 3, at 2 (Apr. 6, 1951).25. Id. at 4.2011]1 115116 Law & Psychology Review [Vol. 35"froia whdt I he ar from -the -out-as the happi t Ithee of our lived 26Dr. David Partlow: You look depressed, my friend. What areyou thinking about?Patient: My future.Dr. Partlow: What makes it seem so hopeless?Patient: My past.27However, the Bryce News's introspection is also speckled with asser-tive humor and a willingness to challenge authority:"I just got out of Bryce Hospital this morning," a traveler tolda fellow traveler on the train. "It's going to be tough facingold friends.""I can sympathize with you," answered the other. "I'm justgoing home from the State Legislature." 2826. Vol. 1-No. 5, at 3 (Apr. 20, 1951).27. Vol. 1-No. 6, at 3 (Apr. 27, 1951).2011] Subversive Apologia 117The patients even felt comfortable writing directed comments on par-ticular doctors:-------------"No, my good man, _these pills do notoure :insanity If- thy di I wouldtake 'thect iayself." 12928. Vol. 1-No. 35, at 3 (Nov. 16, 1951).29. Vol. 1-No. 46, at 4 (Feb. 2, 1952).Law & Psychology Review"ISuggest YOU -see, anoth C~j~r~ir-after listening to tho to y ouerife, I find I've taken an llirtene dliketo you..K*1I.30The common refrain, however, was not a commentary on the institu-tion itself but a clear desire to leave the walls of Bryce Hospital behind:BACK HOMEI wish I was back home where the homes nestle in the hills,where meadows never frown. The people are serene as willowtrees. They take the time to greet whether known or not. Iwould like to go down a dusty road and end up in a vacant lotnot so far [sic] a white church where many blessings have fal-len. The rings on the trees are tarnished now, the carriagesand buggies are empty. I have picked one by one the prettieststars that I have ever known. They have faded upon the coldcold cheeks of the night as tears when you have rolled toflower your pillow - I have tied my bouquet. Wouldn't it befun to climb in a limber jack pine and swing to my heart iscontent. Wish I could go back to Vicksburg, Miss., strollthrough the park and go in the old dome monument for it to30. Vol. 1-No. 48, at 4 (Feb. 16, 1952).[Vol. 35118Subversive Apologiaecho back the same sweet tune, go up in the observation towerto look as far as I can. Then go down the river to watch themload the boats. Wouldn't it be fun to roll in the saw dust pileand end up in the violet bed?Elizabeth Feaser3 1PLEASE RELEASE MEPlease release me, let me goI've been here much too long, you knowThe nurses here are good as gold,But the scenery is getting pretty old!My Doctor is the best at Bryce,And to tell it straight he's pretty nice,But doctors are not all I needPlease let me go, I beg, I plead!There are many places I could be0, if from Bryce, I could fleeAway to some far away placeWhere no one had ever seen my face!Patricia Ann SchoberWard 35 East3231. Vol. 14-No. 9, at 4 (May 16, 1964).32. Vol. 20-No. 9, at 3 (Aug. 7, 1970).2011]1 119

Subversive Apologia Symposium: The Right to Treatment and the Road Ahead

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Subversive Apologia Symposium: The Right to Treatment and the Road Ahead

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