In a Different Key

by John Donvan

  As always, little changed in the aftermath. The institutions remained, and Archie Casto remained in an institution. It can never be known what sorts of abuse he personally endured, beyond what they did to his teeth. As it happened, however, a portrait of the very place he lived was put together by a newspaper reporter named Charles Armentrout, who wrote for the Charleston Gazette. Armentrout snuck into the Huntington State Hospital in 1949, to report on what he saw there simply by walking its “wood-rotting room[s]” and “dimly lighted hallway[s].”

  He was shocked by what he experienced. It is very likely that he saw Archie, who, at thirty-six, was by then one of the “lifers.” But it was the plight of the children that most disturbed Armentrout—children with nothing to do all day, with no toys, and with little or no clothing, covered in their own filth. Their lack of toilet training appalled Armentrout, and the resulting odor of the place—what he called the “odor of the mentally ill”—seemed to overpower him.

  To Armentrout’s eyes, the wards looked like a sure firetrap. “Locked up like common criminals,” he reported, “the girl [s] mentally deficient, like the boys, must find their play on the wooden, fire-hazardous corridor floor.” Elsewhere, he again referred to the “quarters of the youngsters” as “fire-trap structures.”

  He was prescient. One cold November night, three years after his exposé, Armentrout stood on the grass of the hospital grounds looking up at the flames chewing through the female-only building, regretting, as he listened to the screams, that his story’s early warning had changed nothing. In fact, when his 1949 story appeared, six state legislators had banded together vowing to “provide needed relief.” But the effort led nowhere, and a spending bill to fireproof the hospital, finally approved in 1952, was dropped just before the fire broke out.

  It started just before seven o’clock on the night before Thanksgiving eve, in the basement of a three-story building housing some 275 female patients—four times the population the architects had planned for. The mattresses were an easy feast for the flames. An eighty-nine-year-old woman was swallowed by fire, still tangled in her bedsheets, unable to rise. Those who were up and able to walk, however, could not reach the rickety spiral staircase on the back of the building, the only remaining escape route, because the doors of the ward were locked.

  Their faces could be seen pressed against the wire mesh over the top-floor windows. Ladders were quickly raised and reached the windows easily, but then firefighters had to climb back down to get blowtorches to cut through the mesh. Once inside the building, firefighters ran from ward to ward, unlocking the doors, giving nearly three hundred patients a chance to run for it. Not all made it. In addition to Ada Carver, the old woman in the bed, another thirteen lost their lives that night. Five girls, all under the age of sixteen, were suffocated by smoke. One—Lena Wentz—was only eleven.

  Yet even this tragic fire did not bring about a reversal in the pattern of short memories and indecent neglect. In 1967, a new generation was stunned by a photo-essay published in Look magazine exposing the appalling treatment of children and adults locked away in several institutions for the mentally disabled. Authored by Burton Blatt, an educator; Charles Mangel, a journalist; and Fred Kaplan, a photographer, it was based on a book Blatt and Kaplan had published a year earlier with the unforgettable title Christmas in Purgatory.

  Over the holidays in 1965, Kaplan had clipped a hidden camera on his belt, and he and Blatt had entered five different institutions. The photos, along with Blatt’s accompanying text, reported the same story that “Bedlam” had, twenty years earlier. It was the same “dirt and filth, odors, naked patients groveling in their own feces, children in locked cells, horribly crowded dormitories, and understaffed and wrongly-staffed facilities.” Blatt and Kaplan’s account provided still more evidence of the nation’s unthinking abandonment of the disabled, creating, Blatt wrote, “a hell on earth…a special inferno…the land of the living dead.”

  “We now have a deep sorrow, one that will not abate,” Blatt wrote, “until the American people are aware of—and do something about—the treatment of the severely mentally retarded in our state institutions.” In accordance with the times, Blatt and Kaplan’s vocabulary relied much on the word “retarded,” but in all other ways they were pleading for a real break with the past. Before long, Blatt would conclude that the only answer was to close down the institutions altogether.

  Still, the institutions remained, so that in 1972 they were discovered yet again by a young lawyer-turned-journalist named Geraldo Rivera, who reported his first big story by sneaking onto the grounds of a New York City institution called Willowbrook. Rivera became an overnight star partly for the way he communicated what television never captures. “I can show you what it looked like and what it sounded like,” he told his viewers, “but I can never show you how it smelled. It smelled of filth. It smelled of disease. And it smelled of death.”

  —

  ABUSE, NEGLECT, INDIFFERENCE, DEPRIVATION—these were never consciously designed into institutional life, but they ultimately defined it. During his long life behind the walls, Archie Casto lost the little bit of language he once possessed. He failed to grow and pulled deeper inside himself. His ability to smile began to flicker out, and one day simply disappeared. Now, his sister Harriet noticed, his face fell permanently into what she would think of as his “stony look,” an expression of pure hopelessness.

  Harriet knew this because she had continued making discreet visits to the institution, encouraged to and sometimes accompanied by their mother. Clara Casto might have believed her son’s insanity to be “worse than death”—requiring lifelong secrecy—but she still wanted to maintain contact with him.

  Harriet never did see the back wards at Huntington. For visits, patients were always made to look presentable, then brought down to the front reception area—a clean, orderly space where Harriet could sit face-to-face with her brother. Archie was fully mute now, and his stony look didn’t offer much encouragement. But she made it a point to speak on the assumption that he understood what she was saying.

  When she ran out of things to say, whether news from home or comments on the weather, she would chat instead with some of the attendants nearby, who sometimes had bits of information to share on her little brother’s life upstairs. That’s how she learned that Archie had picked up several institutional survival tricks, like rolling up his clothes at night to make a pillow out of them, so they would not be stolen, and always eating with one arm shielding his plate of food, for the same reason. These stories, while far from uplifting, at least showed a boy capable of learning and surviving.

  The attendants she spoke with remarked that it was rare to see family members dropping by as often as Harriet did. They told her that most relatives simply “dumped” their loved ones in the institution and never came back. Archie’s family, they said, was “unusual” that way. It was unclear whether Harriet was being complimented or gently chided. Either way, her presence in the visiting room told the staff something unusual about Archie himself: though institutionalized, he still had family who cared about him.

  The perception that nobody cared was the ever-present danger in the lives of all institutionalized patients like Archie. Never was there a constituency so denied the chance to be heard—or even seen—than the occupants of these massive warehouses for people. Geographically, they were out of earshot. Physically or developmentally, many were unable to speak. Politically, they had no chance to vote. In short, those on the inside needed someone on the outside to battle for them, and such outsiders hardly existed. For all her commitment to visiting Archie, it never occurred to Harriet, in the 1930s and 1940s, when she herself was a professional woman working in university administration, to challenge the decision-making authorities. That’s not what decent people did, not in that era.

  At least Archie had those visits from his sister. And then, suddenly, they stopped. One day, when Harriet dropped by the hospital, she was informed that the state
had transferred her brother to Spencer State Hospital, more than 100 miles away. The family had not been informed, probably because it no longer had any say over Archie’s fate. He belonged to the state. Conditions at Archie’s new home, Spencer State, were described by a therapist who began working there in 1964 as “the worst I’ve seen anywhere that I have ever worked.”

  This, then, was where Archie Casto was to vanish, yet one more time—not just from the outside world, but this time, from his sister Harriet’s life as well. Though in her forties, Harriet had never learned to drive and had no way to get there. For all intents and purposes, Archie was now lost for good, lost in a system that would never be kind to him, never help him grow, learn in school, or explore—and never understand that he had autism.

  15

  THE RIGHT TO EDUCATION

  Tom Gilhool was never, strictly speaking, an autism guy. He never did much reading on it, never had relatives who dealt with it. Before he became involved, he probably would not have been able to say with certainty what autism looked like.

  Not that it mattered in the long run, because Tom Gilhool was an underdog guy, a champion for the disadvantaged. He was also a smart lawyer. It was this combination that thrust him, in the early 1970s, into a decisive legal battle on the side of an organization known as PARC. It stood for the Pennsylvania Association for Retarded Children. It was these parents’ children Gilhool would fight for. The state had failed to provide them with an education, leaving the children whose families could not afford private school to languish at home all day, or to waste their days confined inside the massive state-run institution known as Pennhurst.

  This was at a time before the word “retarded” had fully acquired its toxic connotations. This was also at a time when the parents of children with intellectual disabilities—as opposed to parents from the autism community—were the more experienced, battle-scarred trailblazers in the fight to reform how society responded to developmental disability. Their activism had begun decades earlier, with the founding of the National Association for Retarded Children in 1950, of which PARC was a state chapter.

  In those years, the parents of children labeled “MR,” for mentally retarded, and the parents of children with the lesser-known condition called autism represented two separate camps, and were also to some degree rivals. They both wanted to be first in line for the attention of politicians, and they both wanted to be first in line for donor dollars. The divide between them gave rise to multiple ironies, as the two sets of kids actually showed a large overlap. In the late 1960s, for example, epidemiologists showed that roughly three-quarters of children diagnosed with autism were also intellectually impaired.

  Yet certain autism activists, Bernie Rimland among them, seemed to prefer to keep a distance between autism and the question of intellectual disability. Like Leo Kanner in the beginning, Rimland believed that autism always came with relatively normal intellectual functioning. When making this case, Rimland betrayed some biases of his own, contrasting the “dull, vacuous expression” of the truly “feeble-minded” with the “beautiful and well-formed” child with autism, whose facial expressions he described as “strikingly intelligent.”

  Another irony lay in the fact that the two sets of parents faced nearly identical obstacles. Institutionalization, as the default solution, had failed all of their children. So had the school systems. But in 1969, the parents from the MR side of the divide—the group in Pennsylvania—set out to force change by taking the Commonwealth to court, citing a dereliction of duty to educate all children. They did so without the involvement of autism parents, who were still only beginning to organize. But autism parents everywhere would soon owe a great debt to the group from Pennsylvania—and the lawyer they turned to.

  —

  TOM GILHOOL WAS not familiar with PARC when, in the winter of 1969, two parents representing the organization dropped by his office to discuss the prospects of bringing a lawsuit against the state of Pennsylvania, which owned and operated the Pennhurst State School. When Gilhool confessed to not even knowing what the letters of PARC stood for, one of his visitors, Dennis Haggerty, said, “Tom, I guess now I’m going to have to teach you about mental retardation.”

  That’s where he was wrong. “Dennis,” Gilhool said back to Haggerty, “you don’t need to explain it, because my brother is retarded.”

  It went further than that, actually. Gilhool had been out to Pennhurst many times during his youth. His mother had committed his brother Bobby there in 1953, the year Tom turned fifteen. Bobby was nine then. On visits to his brother, Gilhool had not seen a “snake pit” institution—not quite. He found the staff he encountered generally pleasant, and there were some attendants Bobby was particularly fond of. But it was clear someone was beating Bobby up from time to time. He would show up for visits with swollen ears, like boxers have. Tom was against keeping Bob in an institution at all, but after his father died, his mother, who belonged to a different generation, insisted it was best for him and for the family.

  As he explained this to the two men from PARC, Gilhool could see past them, through the single long window of his narrow, corridor-shaped office, down to the neighborhoods of South Philadelphia. The streets of South Philly were where he had spent many years building his activist skills. A Lehigh and Yale man in bow tie and sideburns, he was part of that generation of young people who felt summoned to put some skin in the game by President John F. Kennedy’s challenge to “ask what you can do for your country.”

  Gilhool, when he finished law school in 1963, was already planning to work on behalf of the disadvantaged, because of his brother Bobby. The great cause of the day was civil rights, so Gilhool dove into campaigns like the Philadelphia Tutorial Project, which brought tutors out of Philadelphia’s elite universities into poor neighborhoods; worked with Community Legal Services, a provider of legal expertise to the poor; advised a successful Welfare Rights Organization campaign to convince Pennsylvania’s governor to increase state assistance to needy families; and helped in the establishment of a network of “self-help centers” that negotiated a truce among Philadelphia’s street gangs, ending the most deadly streak of intergang killings in the nation at that time. In the changing role of lawyer as agent of social change, Tom Gilhool, at a young age, could boast plenty of battle scars.

  The parents from PARC had sought him out for this very reason. They wanted a “rights” lawyer, and they wanted a “rights” argument. Constitution-based arguments were defeating policies like racial segregation in the schools and ensuring minorities the right to vote. In court, as opposed to legislatures and governors’ offices, it seemed that the weak stood a fighting chance.

  PARC’s parents, for some time, had been demanding reforms at the Pennhurst School. Recently, the mother of a boy named John Stark Williams had only been informed of his death upon her arrival to visit him, although he had died nearly a year earlier. PARC investigated the school’s claim that he had slipped in the shower and discovered that he had actually died of burns. When confronted by a PARC representative, a school administrator responded, “Well, these things happen. We’ve got twenty-eight hundred people here.”

  When that story was told at PARC’s annual convention in Pittsburgh that year, and slides from the autopsy were shown, the outraged group immediately moved to initiate proceedings against the state of Pennsylvania. Its goal was to force the state to shut Pennhurst down, or to require the state to demonstrate just cause for its continuance as a state facility.

  The meeting in Gilhool’s office lasted two hours. A few days later, Haggerty picked Gilhool up in his car and drove him out to the state capital, Harrisburg, to meet PARC’s full board. “I can do this,” Gilhool told them.

  —

  GILHOOL WAS AN intellectual tortoise. He spent most of the rest of that year reading widely, talking with experts and activists in the field of intellectual disability, and thinking through the kinds of constitutional arguments that would move him, if he were a judge.r />
  Nine months later, he thought he had it. He presented his clients with a nine-page battle plan whose key words were “the right to education.” Gilhool wanted to build an argument around the fact that children kept locked up in the so-called state schools were not really at school at all. He believed this would resonate in court because education was a topic on which federal judges had been well briefed in a long series of cases stemming from the civil rights movement. The denial of full educational services at Pennhurst, and in school districts across the state, Gilhool wanted to argue, amounted to a violation of the Fourteenth Amendment’s guarantee of equal protection under the law.

  Such an argument would challenge all kinds of conventional wisdom. It would assert, first of all, that people inside institutions had full rights to begin with, and that segregation behind their walls amounted to a denial of those rights. He would also need to challenge assumptions that it was a waste of effort to educate people labeled “ineducable.” These seemed enormous barriers to get across. But PARC wanted to try, and so did Gilhool.

  The surprise came in just how quickly the barriers fell. The trial commenced on August 12, 1971, eight months after Gilhool first filed with the court. A three-judge panel had set aside two days for argument. A large team of lawyers, representing the state, sat together at a table to the judges’ right. Gilhool, in bow tie as always, sat alone at the table opposite. He had seven witnesses to present—all experts on special education and human development. They had all prepared fastidiously, but in the end, some of them did not even get the chance to testify.

  Early on the afternoon of the trial’s first day, after Gilhool’s first four witnesses had testified, an attorney for the state, the assistant attorney general of Pennsylvania, interrupted the proceedings and asked to address the court. “Your Honors, we surrender,” the opposing counsel told the judges. Gilhool was stunned. That was it. The trial was over.