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 you most during your research?
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.
What did you learn about patient treatment in insane asylums?
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.
What else can you tell us about Willard Asylum?
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.
Your first novel, The Plum Tree, is loosely based on your mother’s experiences growing up in Germany, and follows a young woman through the chaos of WWII as she tries to save the love of her life, a Jewish man. How was writing What She Left Behind different?
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!
Are there any similar themes in The Plum Tree and What She Left Behind?
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.
A READING GROUP GUIDE
WHAT SHE LEFT BEHIND
Ellen Marie Wiseman
ABOUT THIS GUIDE
The suggested questions are included
to enhance your group’s reading of
Ellen Marie Wiseman’s
What She Left Behind.
Discussion Questions
1. When Izzy first arrives at Willard, she’s afraid to go inside the old buildings because they remind her of visiting her mother in the psychiatric ward. She also has a difficult time handling the contents of the old suitcases because they remind her of the dead and dying. Some people would find the abandoned asylum fascinating, while others would stay away. Would you want to go inside the buildings? Would you want to go through the old suitcases?
2. Before coming to live with Peg and Harry, Izzy cut herself to deal with her emotions. Self-harm is most common in adolescence and young adulthood, usually appearing between the ages of twelve and twenty-four. Have you ever heard of self-injury as a way of dealing with emotional pain, anger, and frustration? Why do you think some people hurt themselves as a way of coping? What do you think would have happened to Izzy if she had lived during Clara’s time?
3. Displaying opposite ends of the spectrum when it comes to a mother’s protective instinct, Izzy’s mother shoots her father to protect her, while Shannon’s and Clara’s mothers do nothing to protect them. Discuss the maternal instinct. Do you think it’s stronger in some women than in others? Do you think the difference is due to circumstances, as in the way women are brought up, or do you think the difference is due to genetics?
4. Clara tries everything she can think of to get out of Willard. Is there anything else she could have tried?
5. New York State has sealed the medical records of former mental patients, even denying access to the descendents. Why do you think they remain sealed? Do you think this law should be changed?
6. How d
o you think Izzy changed over the course of the novel? How did Clara change? What were the most important events that facilitated those changes?
7. At first, Dr. Roach truly believes Clara needs help, partly because of Clara’s father’s stories, and partly due to the era, when emotional outbursts were often seen as a sign of mental illness. Why do you think Dr. Roach refused to release Clara even though Bruno confirmed the truth about why she was there? Why do you think Dr. Roach committed Bruno to the asylum? Do you think Dr. Roach was more worried about his reputation and his job, or concealing the fact that he took Clara’s child?
8. Izzy refused to visit her mother in prison because she was afraid. Do you think she was angry with her mother, or just sad and scared?
9. Clara refused to go along with the arranged marriage to James because she was in love with Bruno. She had no idea her father would send her to an insane asylum. Hindsight is always 20/20 and, in Clara’s time, women were still subject to the whims of their husbands and fathers, but what would you have done in that situation? Would you have obeyed your parents’ wishes and married James? Would you have continued seeing Bruno?
10. Bruno had no idea Clara was at the Long Island Home because he never received her letters. Izzy couldn’t understand why her mother shot her father until she read her mother’s letters. Can you think of an instance in your life that would have turned out differently if you’d had more information ? Do you think most people jump to conclusions, or that they try to find out all sides of a story?
11. Nurse Trench presented a tough exterior while hiding a soft interior. How did you feel about her when you first met her? How did you feel about her when she was an old woman? Do you think Nurse Trench could have tried harder to help Clara while she was at Willard? What could she have done?
12. Izzy feels like nothing will ever change when it comes to bullying. What do you think? What can be done to make those changes? Do you think we’ve made progress when it comes to bullying, or do you think things have gotten worse?
13. Clara is sterilized after she gives birth, because Dr. Roach felt it was his duty to keep her from passing along “inferior” genes. Do you think it was right for doctors to make that decision for patients who were considered mentally ill? Do you think the government should have a say in who can and cannot reproduce? How far do you think we’ve come when it comes to a woman’s reproductive rights and the right to choose?
14. Bruno had to nail Clara inside a coffin for them to have a chance to escape. Would you have been able to stand being nailed inside a coffin if it meant a chance to be free?
15. During the flood in the electroshock therapy room, someone grabs Clara underwater. Who do you think it was?
16. Do you think reuniting Clara with her daughter helped Izzy heal? In what way? How do you think Clara felt when she saw her daughter?
17. What She Left Behind is composed of two interweaving story lines—Clara’s in the past and Izzy’s quest in present day. Discuss the structure of each narrative. Did you enjoy the alternating stories and time frames? What are the strengths and drawbacks of this format?
18. Which “voice” did you prefer, Izzy’s or Clara’s? Is one more or less authentic than the other? If you could meet one of the two characters, which one would you choose?
19. How are Clara and Izzy the same? How are they different?
20. What do you think Izzy’s future looks like? What about Clara and her daughter’s future?
KENSINGTON BOOKS are published by
Kensington Publishing Corp.
119 West 40th Street
New York, NY 10018
Copyright © 2014 by Ellen Marie Wiseman
All rights reserved. No part of this book may be reproduced in any form or by any means without the prior written consent of the Publisher, excepting brief quotes used in reviews.
Kensington and the K logo Reg. U.S. Pat. & TM Off.
ISBN: 978-0-7582-7845-6
ISBN-10: 0-7582-7845-4
eISBN-13: 978-0-7582-7846-3
eISBN-10: 0-7582-7846-2
First Kensington Electronic Edition: January 2014
What She Left Behind Page 35