The Philadelphia State Hospital at Byberry: A History of Misery and Medicine (Landmarks) (PA)

by J. P. Webster

  The hospital will be known as the Philadelphia State Hospital and its objective will be the most humane and modern treatment of the mentally ill.

  Employees of all grades are invited to carry on with this objective in view.

  Partisan politics and human misery are not compatible. Therefore, political activity on the part of all ranks is proscribed.

  Dismissals from the institutional service will be made only for a cause.

  Abuse of patients, mental, moral or physical, is the unpardonable sin of mental hospitals and will neither be tolerated nor condoned.

  A mere month later, he reported the situation as “hopeless” and claimed he had inherited a “medieval pesthouse.” He was, however, able to raise its standards to “the equivalent of a seventeenth-century asylum.” Woolley himself admitted that the only real way to solve the problem at Byberry was new buildings—and a lot of them. He did succeed in correcting, as he put it, many basic evils. In March 1939, Woolley ordered six hundred double-decker beds to use in the male group. “Although nothing but new buildings can correct entirely the overcrowding,” he said, “the double-deckers, plus nine-hundred single cots, will help bring a measure of relief to our 5,560 patients, thankfully down from 7,000. I want everyone to know of my institution’s need. Philadelphia State Hospital belongs to the taxpayers, and it is up to them to make it as fine a mind-restoring place as it can be.”

  Woolley did what he could to develop extracurricular and recreational activities for his patients. Although his budget allowed for very little hospital-sponsored patient recreation, Woolley found other ways. In 1939, for example, he was more than happy to allow charitable bandleader Vincent Lopez to experiment at Byberry with what he called “swing therapy.” Lopez claimed that the stimulation caused by live music was a real form of therapy and should be treated as such. After playing to four hundred cheering, clapping patients, Lopez said, “Jitterbugs gave me the idea. I concluded that if a jam session excited sane youngsters into a frenzy of wild antics and weird gyrations, then certainly it would be worth experimenting to see what effect the strong, primitive vibrations of a swing band would have on mental patients.”

  Woolley assumes superintendency, 1938. Left to right: Dr. Charles A. Zeller, Charles I. Engard, Dr. Arthur P. Noyes (standing), Dr. Herbert C. Woolley and Dr. William C. Sandy. Historical Society of Pennsylvania.

  The presence of Lopez and his band at Byberry drew the press, and Woolley used the occasion to boost public morale on Byberry. “There is so much that we don’t know about treating mental disorders that we are willing to try anything,” he mused. “Who knows? Perhaps swing music will set off a spark in some patients that may lead to complete recovery.” After Byberry, Lopez took his swing therapy to other institutions and achieved positive results.

  Woolley made very public his criticisms of the hospital to avoid ending up in the awkward position of his predecessors. He called attention to the physical character of the buildings. “Bathing facilities are insufficient and inadequate, the shower heads frequently being empty cans with holes punched therein. Floors are worn out and actually dangerous in places. Scrub water runs through to the floor below. On some wards, the floors give like thin ice as one walks across. Cracks are wide and collectors of dirt. The ward dining rooms are, for the most part, disgusting both in appearance and odor. In fact, there is only one English word that describes the smell, and that is ‘stink.’”

  The new superintendent also spoke of the hospital’s staff, whom he called mostly inadequate. The staff-to-patient ratio was at a miserable low of 1 to 193. When inquired as to his opinion of Stern’s exposure of the hundreds of nude patients and the lack of clothing, Woolley replied, “Sufficient clothing of any description was not available to relieve the crowded condition of the wards by taking the patients out of doors in fine weather to say nothing of cold weather out-of-doors exercise, and at times, ambulatory patients could not go to the general dining room because of nakedness.” Woolley also pointed out that total supplies for the year amounted to $85,279, or a pitiful four cents per patient. He reported that the social service staff were all dismissed by force for lack of submitting their resignations. “The greatest value of this place now is negative,” he said. “It shows how a hospital should NOT be run.”

  Concluded in the Shapiro committee’s report was its recommendations for modern buildings, rehabilitation of Johnson’s existing buildings and a complete redesign of the hospital’s infrastructure. The first thing the state calculated was the cost of the buildings and the number of new staff their operation would require. But most of all, it needed to be determined how much the new hospital would cost to run. The answer was, by 1938 figures, about $2 million a year. The General State Authority (GSA) began accepting bids for the new buildings at Byberry in 1939. It appropriated $7.5 million for construction. In 1940, the board accepted the designs of George Wharton Pepper Jr. and moved the project forward.

  Son of City Councilman George and grandson of University of Pennsylvania provost William, Pepper had been a semi-successful architect as part of the firm Tilden, Pepper and Register. It was most likely his family connections that boosted his career with a large number of contracts for the GSA, resulting in his departure from that firm. As an official GSA architect, Pepper designed many buildings at state hospitals in Pennsylvania during the 1940s. He also designed schools and other public buildings. Pepper’s revised building plan from 1940 shows a small city. It called for the construction of almost fifty new buildings, sprawling across three-quarters of the hospital’s almost one thousand acres. Of these proposed buildings, only about an eighth would come to be constructed. Continuing the 6 percent commission system, Pepper would have upward of $300,000 coming his way.

  Aside from Pepper, other firms such as Ballinger and Co., Davis and Poole and Day and Zimmerman submitted plans for buildings. Day and Zimmerman performed a geographical survey of the property in 1940, for which it was paid $25,000. The Ballinger firm had drawn up plans for new buildings in conjunction with a WPA contract in 1938. But by 1941, the contract had gone stale, and Pepper inherited the entire project. This immediately looked like a replay of the Johnson scandal and began to raise questions. GSA director David Diehl responded, making it clear that the contract was on the level. “There is no assurance that Pepper will be the only architect engaged, he has not been given a blanket commission for the project,” Diehl said. “He has been engaged to do whatever the Authority assigns to him. He will work in cooperation with our architects and engineers.”

  Beds for three hundred men in building A. Historical Society of Pennsylvania.

  Maintaining the same basic group layout, the State’s plan called for the addition of a North Group. This inadvertently, due to geographic boundaries, caused the former West Group (women’s group) to be re-designated as the Central Group, or “C” buildings, as two new building groups were to be erected north and south of it. They also were to receive thorough renovations and repairs. The South Group, in addition to the existing children’s cottages and Nurses and Attendants’ Home, would contain the various new building for staff housing. A two-story addition was planned for the existing Nurses and Female Attendants’ Home to make room for 350 more. The East Group, aside from renovations of existing buildings, was not to receive much modern attention. Fireproof garages and a warehouse for the hospital’s supplies built along the connecting railroad line to the west power plant were also in the works.

  Construction of the commonwealth’s new buildings at Byberry marked an inspiring new attitude toward Philadelphia’s treatment of its mentally challenged population. The new Republican reform governor Arthur James carried on the construction process publicly and openly, and the future looked bright for Byberry. The first building the State erected was the “Workers’ Building,” a building for working patients. The building was designated “S-1” building on Pepper’s plans, as it was located in the South Group, below the children’s cottages (PIFM), west of Route 1.
It would contain a cafeteria, a library and 350 beds. This impressive two-story building, like the rest of the buildings planned, was very general in appearance. Governor James himself broke the ground in 1941 to the roars of hundreds of guests, and the construction began.

  Vincent Lopez demonstrates his “Swing Therapy” method on ecstatic female patients in 1939. Historical Society of Pennsylvania.

  Byberry was becoming less threatening in the newspapers, which now showed photographs of building construction rather than human destruction, and the public briefly began to embrace the “new” institution. Woolley seemed to be living up to his reputation, and attitudes were changing. Some thought Byberry really could be turned around. But on Christmas Day 1940, the beating death of an inmate, former police officer Paul Hallowell, busted Woolley’s bubble. His hopeful attitude seemed to drop away quickly, and he was soon condemning Byberry as “a disgrace to any community or government which calls itself civilized.”

  Sixty-two-year-old Hallowell, being the fifth case from Byberry that Coroner Charles H. Hersch received in two months labeled by hospital staff as “accidental,” caused an investigation. It was learned that Hallowell’s caregiver, Russell Brough, was on parole from the State Industrial School and was quickly discharged. Hallowell died two days later. The other four patients who died under “mysterious” circumstances were Jacob Nonamacker, David Chodnowsky, William J. Williamson and Grant Wimberly. They were all over sixty years old.

  Shower facilities, East Group. Historical Society of Pennsylvania.

  “It is unfortunate that loose talk, insinuations, innuendos, and aspirations can destroy in a few minutes the two years’ efforts of a loyal, unselfish, tireless personnel to build public confidence and good will,” said Woolley, in response to the investigation. But Byberry was back in the black. Hersch came down hard on the institution and its new administration. The four other deaths came under tight scrutiny, and for the first time, Woolley was feeling the public’s attacks, unfair as they were. Woolley himself had once critiqued previous Byberry superintendents, but now he understood their dilemma and acted as transparent as possible. “Any official is welcome to conduct any investigation that he cares to,” he told investigators.

  Hersch’s investigation led State Welfare Secretary Arthur E. Sweeney to call in the state police. Every employee was fingerprinted and examined for criminal records. “There is something radically wrong at Byberry as revealed by these ‘accidental’ deaths,” Hersch said. His office interviewed patients and staff, but few were willing to discuss what happened for fear of their own safety. Some patients mentioned a staff member they referred to as “the slugger of Byberry.” A former boxing champion, he used his brute strength to control patients. Hersch’s investigation seemed to lead nowhere.

  Woolley was soon absolved of any wrongdoing by Hersch and his committee, who instead put the blame on “some official in Harrisburg” they could not identify. However, the committee spared little indulgence in their fantastical proposal of a $27-million reconstruction program. They also praised Woolley for turning the institution around and called its transformation miraculous. “In my opinion, Dr. Woolley is doing all that he can with the equipment at hand and is not responsible for the appalling conditions,” reported Hersch. Woolley had reduced the hospital’s number of straitjackets from 1,200 to 4 and reduced the number of patients by over one thousand.

  Less than two months later, in March 1941, another beating death made headlines. Hersch, still stewing, instructed the police to detain the involved staff members immediately. Four attendants were arrested and charged with aggravated assault and involuntary manslaughter after an African American patient, thirty-two-year-old John Smith, was severely beaten, ultimately fatally, on his ward. Hersch this time involved a grand jury after he discovered bruising, broken ribs and internal bleeding at Smith’s autopsy. At trial, Smith’s sister gave tragic testimony that he spoke of the attack before dying at the hospital.

  “They tried to kill me,” Smith told her. “They kicked me and walked on me. Now they’re trying to patch me up, but I’ll never make it.” After months of trial, charges on three of the four attendants in question were reduced to fines after one of them—William Cotonis—pled guilty to involuntary manslaughter and was sentenced to one year in prison. Bulletin writer Paul F. Ellis reported that out of the 281 employees that had been discharged since Woolley’s arrival, over 200 were fired for mistreatment or abuse and the rest for drunkenness.

  Due to the bad timing of these deaths, smack in the middle of the hospital’s redevelopment, they seemed to stick out as sharp points of notoriety that lent heavily to Byberry’s horrible reputation. Unfortunately, the newspapers were almost automatically biased to the Byberry situation by now, and the true predicaments in which attendants found themselves were rarely expanded on or given much merit. More than likely, in many of the cases of attendants beating or murdering patients, self-defense was a plausible argument indeed.

  Record writer Norman Abbott was one of the few who took the attendants’ hazards into consideration. He called attention to the working conditions facing them in his article “The ‘Why’ at Byberry.” Attendants, noted Abbott, if they chose the option to live on the grounds, earned fifty-five dollars a month for fifty-hour workweeks. Their living quarters were in no better physical condition than the patients’ dormitories and not much less crowded. The food they lived on was the same food the patients had to tolerate.

  Architect’s drawing of S-1 building. Historical Society of Pennsylvania.

  According to Abbott, the job of attendant at Byberry was very easy to obtain. Although certain criteria were in place, such as criminal history, the hospital took everyone who applied. Theoretically, if a new attendant was hired, they would sign a pledge not to take advantage of patients, which was custom at most hospitals. But as Abbott points out, Byberry was no ordinary hospital. He wrote about a theoretical new attendant’s first day on the job in building B, which housed 325 violent male patients and had an average of six attendants on duty at a time. The two wings of Johnson’s antiquated and battered building B were being used as day rooms, and the beds were in the wet, dank basement. The day rooms were just as grim. The decorative wood floor had been ripped up and removed after being used as a weapon by patients. In fact, claimed the unit supervisor, the patients will use anything they can as a weapon. In the 1920s, patients in the East Group were given silverware at mealtimes, but that proved too dangerous. Now most of the male patients ate with their hands.

  Abbott’s theoretical new hire, provided he lasted past the orientation, would go through a ten-week training period, where films and lectures were presumed to acquaint him with his new position. But after completion of training (and often before), the new attendant was thrown to his own devices amid 325 violent, insane men who were also hungry…and frustrated. The imaginable conclusion seemed comparable to a warlike experience. Attendants ran and hugged the walls or used a baseball bat (housed for this purpose in the nurse’s station) to get across the crowded dayroom to the exit. The descriptions alone are enough to get the nerves pumping. Compared with the tiny wages the job paid, it is very easy to see why the reputation of the position kept most from even considering it. In Byberry’s case, at least in B building, the inmates were running the asylum. But, as Abbott concluded in his article, “if there were 40 insane to a ward instead of 325; if there were plenty of attendants instead of half the required number; if insane could be sent to the hospital to be treated instead of merely confined, then—Byberry would not be Byberry.”

  One of the most important steps to making Byberry a decent hospital, Woolley said, was the appointment of a new board of trustees. He urged that the new board be made up of psychiatrists and superintendents of other state hospitals instead of “political buzzards.” Byberry was at this time the third-largest mental hospital in the country, containing almost 6,200 patients. New York’s Pilgrim State Hospital was the largest, with about 9,500. But even w
ith such massive numbers, Pilgrim never reached the hideous reputation that Byberry already displayed. In 1941, Welfare Secretary Arthur Sweeny announced that Byberry’s death rate was 8 per week. The year 1940 saw a total of 419 deaths at the hospital, but Sweeny explained that this was normal. “When you have 5,500 patients in a place like Byberry, most of whom are well up in years, it is not surprising that the mortality rate is high,” he said. “Many of the patients at Byberry are senile when they’re taken to the institution. Mental disorders are more prevalent in older people, and therefore the mortality rate in mental hospitals is much higher than it is in other types of institutions.”

  As the war loomed over the heads of Americans, Byberry’s problems seemed less important. Woolley was getting tired of defending his hospital against a constantly nagging public who had no real comprehension of what it went through. Having exhausted himself improving his beloved Byberry, Woolley was done fighting what he called an impossible state budget and submitted his resignation to the board. It read:

  It is with considerable regret that I feel impelled to submit my resignation, to take effect August 31, 1941. In taking this step may I express to the board individually and collectively my deep appreciation for the courtesy, consideration and support I have received. May I also make a matter of record my deep indebtedness and appreciation to my assistants on the medical, administrative, and nursing staffs of this hospital.