Imbeciles

by Adam Cohen

  Dr. Priddy believed in one policy in particular: eugenic sterilization, which he was convinced could quickly and permanently cut off mental defect at its source. By the 1920s many people across the country had come to support sterilization, and more than a dozen states had adopted legislation to carry it out. Dr. Priddy had made it his mission to bring this eugenic cure to Virginia—and because of the position he had risen to in the state’s medical establishment, and the tenacity with which he pursued his goals, he was in a good position to get his way.

  • • •

  Albert Sidney Priddy was born on December 7, 1865, on a farm in Lunenburg County, southeast of Lynchburg. The Civil War had ended just eight months earlier, when General Robert E. Lee surrendered at Appomattox Courthouse, about fifty miles from the Priddy farm. The Priddys soon moved to nearby Charlotte County, and it was there that Albert spent his childhood as one of a large farming family of nine.

  Young Albert began his education in the small town of Keysville, in a four-room schoolhouse with the lofty name of the Shotwell Institute. When he exhausted the local educational opportunities, Albert, a gifted and driven student, traveled north to Baltimore to enroll in its newly established College of Physicians and Surgeons. He graduated in 1886, becoming a medical doctor at the age of twenty.

  Dr. Priddy returned to Keysville and established a practice. Despite his relative isolation, he followed medical advances at the research hospitals in the big cities and overseas, particularly in his specialty of surgery. Dr. Priddy integrated the latest procedures into his own medical work: in 1888 he performed one of the earliest successful operations for a perforating injury of the intestines.

  Despite having a thriving medical practice, Dr. Priddy was drawn to politics. He was elected to the Virginia House of Delegates and, while still treating patients, he represented Charlotte County, which contained Keysville, from 1893 to 1894 and again from 1899 to 1900. Dr. Priddy was a progressive force in the legislature. He helped draft a law requiring a secret ballot in Virginia elections, an important advance for the forces fighting political corruption in the state.

  Dr. Priddy also was an advocate for an issue that was gaining attention in statehouses nationwide: improved care for the mentally ill. He arrived in the legislature at the start of the Progressive Era, a period of idealistic social reform in many areas, including mental health. The progressives had faith that state hospitals, if properly constituted, could make great strides in treatment. As a legislator, Dr. Priddy became a leading advocate for reforming the governance of the state’s hospitals for the insane.

  When his final term in the House of Delegates ended, Dr. Priddy decided not to return to the practice of medicine. His professional interest had turned to mental health, with an emphasis on reforming the way in which the mentally ill were cared for. Dr. Priddy closed up his medical office in Keysville and accepted a position at the Southwestern Lunatic Asylum in Marion, the newest of Virginia’s mental health hospitals.

  Virginia was not a leader on many social issues in the 1920s, but it had historically been a pioneer in mental health. In colonial times, the mentally ill were generally kept in almshouses or jails, or simply left to fend for themselves. The British governor of Virginia Colony, Francis Fauquier, who was the son of a Huguenot physician, believed more should be done for them. He proposed that “a hospital be constructed for the ‘lunatics and ideots wandering helplessly around the country.’” The House of Burgesses agreed, and in 1773 the Publick Hospital for Persons of Insane and Disordered Mind opened in Williamsburg. It was the first hospital for the mentally ill in the United States—older than the nation itself.

  The hospital in Williamsburg, later renamed Eastern State Hospital, was Virginia’s only hospital for the mentally ill until 1828, when the Western Lunatic Asylum—later called Western State Hospital—was established in the Shenandoah Valley. A third hospital, the Southwestern Lunatic Asylum—later called Southwestern State Hospital—was opened in 1887 in Marion. After the Civil War, Virginia established a separate hospital for mentally ill blacks, the Central Lunatic Asylum, which was later renamed the Central State Hospital for Negroes.

  There were now mental hospitals in every part of Virginia, but the state had no hospitals for another group that needed special care: epileptics. Epilepsy was little understood at the time. The medical profession was just starting to move away from ancient prejudices—including the belief that epileptics were possessed by the devil—and it was discovering treatments to suppress seizures. Across the nation, interest was growing in creating new institutions for epileptics based on the “colony” model.

  The move to institutionalize epileptics was in part for their own benefit. Without specialized facilities, epileptics were often sent to mental hospitals, even if they were not mentally ill, or to jails, even if they had not committed crimes. At a meeting of the National Conference of Charities and Correction in 1902, Dr. William P. Spratling, medical superintendent of an epileptic colony in western New York, made the progressive case for building more institutions like his own. Colonies, with their “vocations ranging from . . . weeding the cabbage patch or the making of brick” and abundant “amusements and recreation,” offered “the highest treatment of the disease,” he said.

  The interest in building state institutions for epileptics was also driven by fear. In the early 1900s, America was still caught up in what has been called “the myth of the dangerous epileptic.” There was a long tradition of regarding epileptics as—in the words of one epilepsy expert—“mad and bad, liable to explosive and unpredictable attacks of violence and insanity, perhaps murder or at least moral depravity.” For those who feared epileptics, segregation in far-off institutions was an ideal solution.

  There was interest in the Virginia legislature in establishing a special state hospital for epileptics, and in 1905 an unusual opportunity presented itself. A wealthy resident of Amherst County, southwest of Charlottesville, left two hundred acres of land to Western State Hospital so it could provide “extra Comforts” to its patients. Sidney R. Murkland had acted in gratitude for the treatment his son received at Western State. Even though the bequest was designated for the hospital’s general use, supporters of an epileptic hospital saw an opening.

  The legislature passed a bill authorizing Western State Hospital to erect on Murkland’s land “all suitable buildings and appurtenances for the establishment of a colony for the reception, care, treatment and employment of three hundred epileptic patients.” It also allocated $25,000 for building construction. The legislature noted that the new facility would serve dual purposes: providing specialized care for epileptics and reducing the overcrowding in “existing State hospitals for the white insane,” which were filled to capacity.

  It was now settled that Virginia would have an epileptic colony, but not everyone agreed the Murkland land was the right location. The State Hospital Board objected that it was “very inaccessible,” a situation made worse by the fact that it would be hard to get a spur track on the site, which meant railroad travel would be difficult. The hospital board also insisted that an epileptic colony should have a working farm. The donated land was of poor quality and cut up with ravines, the board said, making it “of practically no value as farming land.”

  The State Hospital Board and the legislature began looking for a better site. Western State Hospital sued, arguing that it was the beneficiary of the Murkland bequest and if the land was going to be used for an epileptic colony, it should be part of Western State. Western State lost its suit, however, and the Murkland land was sold. The proceeds were used to buy a parcel about fifty miles away, two miles outside of Lynchburg, which would be the home for the state’s first hospital for epileptics.

  • • •

  The Virginia State Epileptic Colony, as the new institution would be called, needed a superintendent. On April 8, 1910, the colony’s board appointed Dr. Priddy of Southwestern State Hospital. As
a medical doctor, a state hospital administrator, and a former member of the House of Delegates, Dr. Priddy brought a rare combination of skills to his new position. His first major responsibility, however, was an undertaking he knew little about. He had to build a facility for housing and treating hundreds of resident epileptic patients.

  The State Hospital Board was proved right about the new location: nestled high above the James River, the wide and majestic tidal river that British colonists named after King James I, the colony sat on a lush 1,020-acre campus. There was considerable room for facilities, recreation, and, most important, farming. Dr. Priddy would soon put 350 acres, or more than one-third of the campus, under cultivation.

  Though far better suited for a colony than the Murkland parcel would have been, the site was not without its drawbacks, starting with its remote location. In the colony’s early days, the roads leading out to it could not be relied upon, particularly after it rained. The first time the governor visited, he got stuck in the mud and remained trapped until help arrived from Lynchburg. In the next legislative session, funds were allocated to pave the roads between the highway and the colony.

  When he took charge, Dr. Priddy presided over a flurry of construction. Two buildings that were already on the grounds were renovated: one became executive offices and the other a residence. On March 1, 1911, the colony’s first new structure, the Drewry-Gilliam Building, was completed. The first epileptic patients moved into the colony on May 16, a little more than a year after Dr. Priddy took over.

  In its first year, the colony admitted about one hundred patients, all epileptic men. The first wave included thirty epileptics who had been inmates at Eastern State Hospital, thirty from Southwestern State, and forty from Western State Hospital. The very first patient to move in was a thirty-seven-year-old man who illustrated well why a specialized institution for epileptics was needed. Before arriving at the colony, he had been confined to a mental hospital for thirteen years, though he had no mental defects.

  Epileptics were better off at the colony than they would have been at a mental hospital or a jail, but their situation was still far from ideal. The colony had little to offer epileptic patients in the way of medical treatment or therapy—or help in returning to society. The colony was necessarily “custodial in character,” a history of the institution noted. “Lack of personnel and facilities restricted the operation to that level.”

  If the colony could not offer cures, it did provide modest recreations and diversions. There were weekly dances, Thanksgiving and Christmas dinners, and a summer watermelon feast. Inmates were given leaves to attend moving picture shows in Lynchburg, and every residential building had a phonograph for the inmates’ use. For the more spiritually inclined, services were held in the colony’s chapel every week, Methodist and Baptist on alternating Sundays.

  In keeping with the colony model, inmates spent much of their time working out in the fields. They raised fruits and vegetables both to eat fresh and to be stored for the winter. Dr. Priddy would eventually be able to boast that the colony “has bought no canned goods for two years.” The colony had its own cattle farm and the hog herd alone yielded twenty thousand pounds of pork a year, an amount that was “ample for supplying the institution with salt meat.”

  As an administrator, Dr. Priddy emphasized thrift in all things. He took satisfaction, he wrote in one “Report of the Superintendent,” whenever he visited institutions in other states and compared “the condition of their inmates from the standpoints of health, comfort and death rate, and their cost of maintenance.” He invariably found, he said, that Virginia was supporting its inmates “with practically as much comfort and at much less cost to the taxpayers than in most any other State.”

  Dr. Priddy had many ways of keeping expenses in check, which he enumerated in his public reports. His economizing touched on every aspect of the inmates’ lives, and continued even after they died. Dr. Priddy found that funeral costs could be kept to a minimum if inmates were buried on the colony’s grounds. If relatives insisted on holding their own services, they were required to pay the embalming and shipping costs.

  The colony soon expanded its mission. After initially admitting only epileptic men, in 1912 it began to accept the feebleminded, and women inmates, both epileptic and feebleminded. The new admission policies helped to take some of the pressure off of the other state hospitals, which were filled beyond capacity. A few years earlier, the commissioner of state hospitals had warned in a report that if additional accommodations were not made available for housing the mentally defective and epileptics, some of them would have to be held in jails.

  The colony began to fill up with inmates who had been adjudicated as feebleminded, many of them poor women who had run afoul of the police or government agencies. Dr. Priddy took a dim view of many of his female charges. In a 1914 annual report he described one group as unfortunate “creatures,” who were “adept in the use of the vilest language and practices, common among women of their class.” The women “morons” at the colony, Dr. Priddy would later say, “consisted for the most part of those who would formerly have found their way into the red-light district and become dangerous to society.”

  The colony continued to expand. Several new buildings opened in rapid succession: the Mastin-Minor Building, which housed feebleminded women; the Strode-Massie Building, home to one hundred epileptic women; and Lesner-Fletcher Hall, which had an auditorium on the first floor and classrooms below. Another residence, LeCato Cottage, added fifty-six more inmate beds.

  It was no longer accurate to refer to the colony as simply a facility for epileptics. In recognition of its wider mission, on October 1, 1919, the name was officially changed to the State Colony for Epileptics and Feeble-Minded. Over the next few years, an increasing percentage of the new admissions were feebleminded. By 1925 more than two-thirds of the colony’s inmates would be classified as mentally retarded.

  Dr. Priddy carefully managed the inmate population. He insisted on housing feebleminded and epileptic inmates separately. And he drew the line at accepting idiots, the lowest level of Goddard’s hierarchy. “Pitiful appeals in behalf of the admission of idiots continue to be received,” Dr. Priddy lamented in a 1923 report, but “all such applications have to be rejected.”

  • • •

  Dr. Priddy came to the colony at a time when opinions were changing about what to do with the feebleminded. In the early days of the Republic, there was little help available for people with mental difficulties. Unlike Virginia, with its Publick Hospital for Persons of Insane and Disordered Mind, most states left it to local communities to care for people with mental disabilities, who “commonly languished in local jails and poorhouses or lived with family and friends.”

  As the nation’s population increased and became more urban, these informal approaches became outdated. States began to establish public mental hospitals: Massachusetts in 1848, New York in 1851, Pennsylvania in 1853, and Connecticut in 1855. This “cult of asylum” continued to spread, and by the start of the Civil War almost every state had one or more facilities for the mentally ill. It was a sign that the institutionalization movement had reached critical mass when, in 1877, administrators organized the Association of Medical Officers of American Institutions for Idiotic and Feeble-Minded Persons.

  These institutions for the mentally defective began idealistically, with a commitment to “moral treatment and compassionate care—and a conviction that they could do a great deal to help their patients.” In time, however, this therapeutic impulse began to give way. During the Gilded Age, the final three decades of the 1800s, it was increasingly replaced by a darker assessment of people with mental defects and where they fit in the social and biological order.

  For nearly a century, social scientists had been reframing the history—and future—of humanity in biological terms. In 1798 the English political economist Thomas Malthus published An Essay on the Principle of Po
pulation, in which he offered a bleak vision of the implications of population growth. Malthus argued that the world’s population would eventually outstrip the food supply, with only famine and disease to provide a counterbalance. “The power of population is so superior to the power in the earth to produce subsistence for man, that unless arrested by the preventive check, premature death must in some shape or other visit the human race,” Malthus warned.

  A half century later, in 1851, the English philosopher Herbert Spencer argued in Social Statics that rather than being guided by God, humans were evolving based on scientific rules. In that book, and several later ones, Spencer identified a natural sorting process that separated those who were strong enough to survive and those who were not. In his 1864 work The Principles of Biology, he gave this process a name: “survival of the fittest.” As Spencer saw it, the healthiest humans lived and reproduced, while “nature’s failures”—those with mental, physical, or moral deficiencies—did not. “Life has reached its present height,” he said, under a universal law of nature: “that a creature not energetic enough to maintain itself must die.”

  Spencer believed this violent sorting out was not only natural but right. Intervening to help the unfit would weaken all of humanity, “and eventually the degenerate species would fail to hold its ground in presence of antagonistic species,” he wrote. This compassionate course would, he insisted, be “fatal” to the human race. It was dangerous folly for reformers or the government to rescue the poor and weak from the “natural” forces that were defeating them, he insisted. “If they are not sufficiently complete to live, they die, and it is best they should die.”

  Spencer’s pitiless view of the human condition would later be branded “social Darwinism,” but his writings actually preceded Darwin’s. It was eight years after Social Statics that Charles Darwin, the British evolutionary theorist, introduced his observations of the natural world into the discussion. In 1859, in his On the Origin of Species, Darwin argued that animal populations evolve over time through a process of natural selection. There was considerable interest in applying these evolutionary theories to mankind. Darwin would do this himself more than a decade later—but a relative of his did it first.