As if the courts and doctors didn’t have enough power, the Michigan Supreme Court ruled in several cases during the 1930s that some judges were skipping the part of the law that called for the taking of evidence, and were relying instead almost entirely on the two physicians’ findings. After several scoldings from the high court, the legislature stressed in a 1937 revision of the law that judges had to base their decision on facts and not opinions. But the procedures themselves remained much as before, and therefore, so did the outcomes. In essence, if both physicians certified someone as “actually insane,” then most judges would take the next step prescribed by the law and “immediately issue an order for his admission to the proper hospital, home or institution.” Worse, once the judge had issued that order, patients remained insane in the law’s eyes until another pair of physicians, also appointed by the court, had certified their return to sanity.
If the process seemed more in keeping with a criminal proceeding than a medical emergency, that was no accident. The law still reflected concepts of insanity from the nineteenth century, concepts that Eloise and other hospitals no longer embraced. In 1940 legal parlance, the patients were still the “accused” in court, they were “inmates” at the mental hospital, and they were “paroled” on discharge. Today, the pendulum has swung in the other direction, with patient rights so strong that someone who is mentally ill—and whose judgment is impaired—can often refuse treatment altogether. But at the time of Annie’s admission to Eloise, someone charged with a crime in Michigan had more rights than someone alleged to be insane. Not even God, I thought as I read through the law and the court rulings, could help a patient who protested to the judge that such a system was, so to speak, insane.
On a pleasant spring morning, I make a house call. Sandra Peppercorn Ellison, a therapist in suburban Detroit and a friend of my wife’s cousin, is expecting me. As part of my quest to better understand what happened to Annie and my family in April 1940, I’ve decided to consult a variety of psychiatrists and therapists and ask them to help me interpret what I find as I go along. My first consultation is with Sandy, a small, dark-haired woman in her mid-sixties, whose bright eyes and round face give her an elfin look that only temporarily masks her intense curiosity and direct questions.
I had given her a copy of Annie’s records, including the Routine History. After setting a cup of tea in front of me, she dives right in. “Some of my thoughts might be upsetting,” she says. “I just wanted you to know before I start.” I urge her to go on, but I can feel my throat tighten a bit.
She points to a sentence in the Evans report that I hardly remembered, even though I had thought I knew almost every word by heart: “Annie suffered with severe constipation all her life and had to take medicine constantly for it.” I knew that Annie’s constipation was one reason for her frequent visits to the Harper Hospital clinic, but I didn’t attach any particular significance to it. Sandy, however, thinks it might explain a lot. For a teenager, she suggests, going to a hospital clinic for enemas and other invasive treatments can be profoundly upsetting. She speculates that Annie sexualized these procedures, and that she may have found them both disturbing and pleasurable. “It’s one thing when you’re small, and your parents are doing the enema at home,” she says. “But when you’re a teenager, and it’s a stranger…” Her voice trails off.
“If the sexual assault happened, what effect do you think it had?” I ask.
“That’s hard to say,” she says. “It could have been profound, but I wouldn’t describe it as the trigger. It was just one more thing, out of so much that went wrong for her. She had no personal boundaries by that time; starting with her leg, then the constipation, then the amputation, this was a girl who was poked and prodded almost from birth. She was treated more as a specimen than a human being.”
In other words, even if no sexual assault occurred, this was a woman whose personal space was violated constantly.
“What about the final diagnosis, undifferentiated schizophrenia?” I ask, pointing to that phrase in the 1972 document. “What does that mean?”
“It’s a catch-all phrase,” Sandy says. “In 1972, and in 1940. It means they don’t know exactly what to call her condition.” Sandy is skeptical that Annie was schizophrenic, at least at the time of her admission, and she’s certain that if the twenty-one-year-old Annie were alive today, no one would diagnose her as schizophrenic. The definition, she says, has gotten narrower as our understanding of schizophrenia has improved.
Nor, Sandy says, would anyone today suggest confining Annie to a hospital. Not only do today’s laws make it difficult to commit a patient who insists she isn’t insane but, Sandy points out, there are a range of treatments to try before taking such a drastic step, as well as community-based residential programs where Annie could live while learning a skill that might allow her to achieve some measure of the independence she craved.
I write a note to myself, and underline it: “Born at the wrong time.”
“What do you think about Annie’s level of retardation?” I ask. “What would have led Bohn to think that Annie belonged at Lapeer, an institution for the ‘feeble-minded’?”
Sandy shakes her head, vigorously. “I don’t think Annie was that retarded. She probably had a low IQ, maybe 80—the classic ‘slow’ learner. But she could read, and she seemed to be able to carry on conversations.”
Now it’s Sandy’s turn. “Why are you doing this?” she says. “What are you trying to learn?” I give her my usual journalistic answers—fascinating detective story, unknown history of thousands of mentally ill patients, the challenge of finding Mom’s friends from long ago, figuring out why Mom had clung so hard to the secret.
“That’s what you’re thinking,” she says, stressing the last word and fixing her bright eyes on me. “What are you feeling?”
She’s in full therapist mode, but I don’t mind—it’s a question I should be able to answer. I’ve asked myself similar questions, not so much what I’m feeling, but why do I want to make this journey, why is it important to me, not just as a journalist (that seems clear enough), but as a son? Family and friends had warned me that I was likely to find out things that I might prefer not to know, that it could upset the family equilibrium, that no one emerges unscathed from disturbing the ghosts in the family attic. Yet I push on. Why? Sandy’s the first person to quiz me about this directly, and I’m interested in my spontaneous answer.
I tell Sandy that I want to understand how the secret affected Mom, whether it helped explain why she seemed so needy in the waning years of her life, why she had to be constantly reassured that we loved her and wouldn’t abandon her. “It was sad that she couldn’t reveal her secret. It might have brought me closer to her,” I say. “Instead, I found her neediness in those last years annoying, so I put more distance between us.”
Sandy doesn’t say anything, the therapist waiting for me to go on. I sense that she thinks I’m ducking her question, that I’m talking more about Mom than myself. What am I feeling? I try again.
I find myself talking about pain, the pain that Mom endured in the last years of her life, both emotional and physical: her hospitalization for depression in 1995; her broken pelvis from the fall at the family wedding; her agonizing and lengthy recuperation at the Seattle rehabilitation center; her decline once she returned home. I know it’s silly, I tell Sandy, but I feel guilty because I was the one who made it possible for Mom to attend the wedding. I had brushed aside her excuses about how she didn’t feel well enough to go, I had flown to Detroit and rented a car to escort her to the airport, I had made all the arrangements so that all she had to do was pack her suitcase and get on the plane. “I know it’s not my fault,” I say, “but if I hadn’t interfered…”
I describe the night I spent in the Seattle ER, with Mom screaming in pain as I coaxed her to hold still for an MRI, and I feel my voice catch. “I’ll talk when my tears stop,” I say, partly to let Sandy know that I’m not embarrassed to show my e
motions.
She doesn’t try to comfort me. Instead, the therapy session in full swing, she pushes me. “I think you have a lot of pain, too,” she says. “I think you feel a lot of pain about your mom.”
I consider this. I’m conscious, as I wrestle with the implications of what she’s saying, that I don’t believe that the project is my way of dealing with that pain. It’s more complicated than that—isn’t it?—and I can’t separate my motivations, as a journalist, as a writer, as a son, into nice, neat packages. Finally, I say, “I feel pain for my mom—her loneliness after my dad died, her neediness, her guilt about Annie.”
Sandy picks up on the last part. “I’m sure your mom was suffering from depression for a very long time,” she says, “and having a psychiatrist tell her in 1995 that she needed hospitalization, even for a short stay, undoubtedly scared the hell out of her, given what she knew about Annie.”
I nod, remembering that day in 1995, remembering Mom pleading with me to take her home, remembering my guilt about leaving her there.
“That day at the hospital was awful,” I say. “I think that this”—my pursuit of the secret, and trying to discover my mother’s reasons for creating it and keeping it—“is helping me to put that day in its place.”
Copies of Annie’s court file in hand, I knock on the door of Ed Missavage’s house, eager to show my latest find to the former Eloise psychiatrist. The house is a split-level, like so many others built in the 1950s and 1960s in the northern suburbs where Missavage lives, but that’s where the similarity ends. It’s a dramatic glass-walled fort that looks like it belongs in Miami or California or an architectural seminar on modern design. But I can see evidence of wear and tear, as well as Detroit’s wet weather; years of condensation has left its mark here and there, and from the inside, mist on the glass often obscures a clear view of the lush terrain surrounding the house. Missavage’s wife’s death in 1999 left him to fend for himself, and he admits to waging a losing battle against the accumulating clutter of daily life.
Time has taken its toll on Missavage as well, or at least on his body. He moves slowly, his lungs damaged by years of smoking and his legs swollen from circulation problems, and he shuffles more than walks. But his large kitchen table suggests no slowing of his voracious appetite for research and reading; the stacks of papers and file folders leave no place to put the cup of coffee he graciously offers me.
He has promised me some ideas, and he makes good on his pledge. He’s been calling around to find out how I can get the rest of Annie’s medical records, and he says there’s a simpler route than I’ve been led to believe. As Annie’s next of kin, I could open an estate in her name, and obtain something called a Letter of Authority from the Probate Court that entitles me to see her medical records. I’m dubious—why hadn’t anyone told me this back in 2000?—but I’m thrilled to hear that there’s another door to try. I leave him with copies of Annie’s court file, which he agrees to look over.
The next day, back at the Probate Court to pursue Missavage’s suggestion, I discover a hitch. Michigan law does not consider me to be next of kin. That title still belongs to Mom, even though she’s deceased. I’m astonished, but a Probate Court examiner patiently explains that because Mom outlived Annie and was the lone surviving relative from the immediate family, she’s the next of kin in the law’s eyes—and with Mom dead, Mom’s estate has inherited the next-of-kin title.
Even from her grave, Mom still controls access to the secret.
Discouraged, I get ready to leave, but the examiner, a woman in a blue pin-striped suit, is thinking out loud. “There might be another way,” she says. She tells me that as Mom’s next of kin, I could open an estate for her, and if my brothers consent, I could have myself declared Mom’s personal representative, which would give me the power to act in Mom’s name. Then, armed with that authority, I could open an estate for Annie—thirty-four years after her death—and this would entitle me, as Annie’s legal representative, to seek her medical records.
It’s a double-bank shot, with no guarantees, but it couldn’t help but improve my legitimacy in the eyes of Michigan’s mental health system. I’d have two Letters of Authority, signed by judges, giving me certain rights on behalf of both Mom and Annie. My head is spinning. What am I getting myself into? Two estates? Two appointments as personal representative? It’s so complex, so legal, so Bleak House.
But in a way, I’m glad for the complications and even the formality of getting my brothers’ consent. Nothing focuses the mind like a legal document. It would give me a reason to talk with them in greater depth about what I was doing, and it would give them the chance to object if they wanted to. I know that Jeff’s more fascinated than concerned, but that Mike still has some misgivings. Later that week, I call him. We have a somewhat awkward conversation, with both of us trying hard to respect each other’s point of view, but eventually, we make our way to the heart of the matter.
Mike tells me that he’s fine with signing the waiver, but he doesn’t really understand my quest. “I don’t see the point in digging this up,” Mike says. “It’s done with. We can’t stand in their shoes.”
“But that’s what is fascinating for me,” I say. “I want to understand what they did, and why, and how it affected them.”
He’s not persuaded. “I wouldn’t do what you’re doing,” he says, “but this is your project, so I’m glad to sign the waiver.”
I ask him about his misgivings. “I’m not worried about what you might write,” he says. “I’m a little concerned that you might find out things that will be painful for you.” I tell him I’m willing to take that risk.
Even though the conversation verges on uncomfortable at times, I’m delighted—because we’re talking about the issues, not avoiding them. We’re engaging, not concealing. We’re not Mom and Annie.
A week later, signed waivers arrive from Mike and Jeff. A few weeks after that, I open the estates and have the Letters of Authority in hand. Immediately, I make two inquiries about how to request Annie’s records, one at Wayne County for the Eloise files and one with the State of Michigan for her Northville stay. I’m pessimistic about Northville in particular; when the hospital closed in 2003, state law dictated the destruction of all patient records older than twenty years. But I want to know for sure.
And now that I am Mom’s representative, I can also seek access to her medical records, and find out whether she had told her secret to any of her other doctors—and if so, what she might have said.
Several months later, I receive an unexpected gift from Jamie Soliman, a Wayne County Probate Court employee who had gone out of her way to help me navigate the system there. I had asked Jamie, whose curiosity and enthusiasm make her a valued species in the bureaucratic jungle, if she could gather all the involuntary commitment cases from April 1940, so that I could get a sense of how the process worked, not just in Annie’s case but in general. When I arrive to review the files, she tells me excitedly, “I’ve found something I think you’ll be interested in.”
She hands me a letter about Annie, signed by Eloise superintendent Thomas K. Gruber and sent to the Probate Court in April 1940. Jamie had discovered it, misfiled, in another case folder from that same week. In the letter, Gruber invoked his authority, under Michigan law, to keep Annie from attending the hearing on her sanity—a power given to mental hospital superintendents, in a spirit of paternalistic concern, to protect severely impaired patients from a process that might make their condition worse.
“In the matter of Annie Cohen, a patient in Eloise Hospital under a temporary order issued by your court, alleging that this individual is insane,” Gruber’s letter began, “I hereby certify that it is improper and unsafe for the above mentioned patient to appear in your Court at the time of the hearing regarding the alleged mental disease.”
The document itself is more telling than Gruber’s actual words. It’s a form letter, with “Annie Cohen” typed in where the name should go. When I look at t
he half dozen other involuntary commitment cases that Jamie had collected for me, I find three other Gruber form letters, all identical except for the name of the patient. Apparently, it was routine practice to keep Eloise patients from attending their own hearings.
Gruber cited no other information to support his immediate declaration about Annie’s condition, so there’s no way to know why Annie’s doctors believed that it would be “unsafe” for her to go. Gruber’s letter was dated April 27, 1940, the day after Annie’s admission to Eloise. Within twenty-four hours of her arrival, with her hearing date still two weeks or more away, Gruber or his staff had already decided that she would be too sick to attend. Did anyone at Eloise have any second thoughts after Bolewicki, two weeks later, found Annie to be “fairly well oriented as to time, place and person” and found “her calculations to be fair”? Had the psychiatrist treating Annie even seen Bolewicki’s certification?
Somehow, after everything I had read, it seems safe to say that the system wasn’t geared to either reconsideration or appeal. The court had given Annie her day in court, even if she wasn’t there to witness it. From now on, the doctors and staff at Eloise would decide Annie’s future.
{ SEVEN }
Welcome to Eloise
Courtesy of the Walter P. Reuther Library, Wayne State University
“In the practice of medicine, whatever the branch may be, there is no better teacher than that form of experience usually called Hind Sight.”
Annie's Ghosts Page 11