Annie's Ghosts

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by Steve Luxenberg


  His last letter, postmarked July 1, contains no hint of any problems. He said he had just picked up his pay, $5.40 for the month, but the small sum didn’t bother him. “I don’t go anywhere, and I don’t gamble so I can get along. It’s enough for my cigarette rations and beer rations.”

  The morning reports don’t give any details about his illness, but they reveal that everything happened in a hurry. On July 2, the 313th admitted Pvt. Julius Luxenberg, patient number 1560, for “psychoneurosis and anxiety, sev.” That same day, the 313th transferred him to the 80th General Hospital, the largest in Manila and the best equipped to handle psychiatric patients. The next day, the 313th released Pvt. Luxenberg from assignment, and reported that he now belonged to the 80th General Hospital’s Department of Patients. On July 5, the 80th delivered him to Base K at the Philippine island of Leyte, where he remained until an airlift to the States on July 10. On the 80th’s final disposition and admission list, an additional diagnosis appeared: “reactive depression.”

  Lost somewhere in the rush: His belongings, which would include Mom’s letters to him for April, May, and June.

  Dad, too, was one of the thousands, a different set of thousands than Annie’s.

  During July 1945, the military evacuated 6,923 “neuropsychiatric” patients from overseas posts back to the United States, and over the course of the entire war, 127,660. A battle raged within the military’s ranks about how to handle psychiatric discharges—too liberal a policy would encourage fakery, too restrictive a policy would place troops in the field at greater risk. A War Department memo directed draft boards to take time to weed out the unfit before induction. “These cases are disturbing to the morale and discipline of a unit,” the March 1943 memo declared. “They present a problem and an unnecessary burden to unit commanders, often requiring that they be returned to this country after a brief service time overseas.” That description pretty much summed up Dad’s twenty months of duty, starting with basic training; he might well have wondered if his draft board got the memo.

  Darnall, which had a capacity of 871 in its psychiatric wards (and fifty beds for nonpsychiatric patients), handled a substantial percentage of the evacuees during its nearly five years of operation. Like Eloise during this period, it faced an overcrowding problem at times; unlike Eloise, Darnall had no permanent population—patients stayed an average of forty-eight days before returning to duty, getting a discharge, or going to another hospital for longer-term treatment. So many patients flowed through the facility that the Darnall disability boards could hardly keep pace; in 1945 alone, they evaluated 5,774 patients, a rate of more than ten a day, granting disability discharges to 4,443 and returning 748 to active duty. Under Army rules, a diagnosis of “psychoneurosis” required a finding by a three-member panel, including at least one psychiatrist.

  Three months before Dad’s case went to the disability board, the Army surgeon general issued a memo clarifying its criteria for discharge. No patient should be returned to duty unless he can work a full day, the surgeon general’s memo said, and while that standard would undoubtedly result in discharges for soldiers who could do a full day’s work in civilian life, for the Army’s purposes, “their bad attitude and mild residual neurotic disorder made them ineffectual.”

  The Army never resolved its ambivalence about psychiatric discharges, according to its official history of neuropsychiatry during World War II. Like any large organization, especially one put together in haste and comprising career officers and newcomers trained outside the military, the Army had many voices telling it what to do. Some saw disability discharges as a quick way to get rid of a problem soldier; some thought such discharges should go only to the clearly disabled, and resisted the idea of using them to improve morale. As might be expected in wartime, the commanders in the field wielded a good deal of influence as to who did or didn’t qualify, and the Pacific and European commands eventually adopted different policies. For much of the war, most commanders discouraged the evacuation of psychiatric patients, preferring to treat them at field hospitals, figuring that it would be harder to get them back once they were gone. But the Southwest Pacific command, overwhelmed by psychiatric cases and concerned about morale, ordered airlifts to begin in November 1944.

  By July 1945, the airlifts had become routine. On the day of Dad’s evacuation, the 80th General Hospital listed ten other psychiatric patients for evac back to the States.

  When Mom picked up the phone on that July 26 afternoon and heard Dad’s voice, telling her of his sudden evacuation to the States, she might have been thinking about another patient who had just completed a sudden transfer of her own. Two days before Dad’s call, Annie had boarded the bus for that long trip to the Soo, to that temporary hospital in the converted military barracks. Mom was still living in her parents’ apartment, and Eloise must have notified Tillie and Hyman, so it’s hard to believe that Annie wasn’t on Mom’s mind.

  Mom didn’t write Dad on July 24, the day of Annie’s departure to the Soo. Both of Dad’s brothers, Manny and Billy, had arrived to see her and her new baby, and she cooked dinner for them, along with Hy, and Hy’s sister Rose. It was one of those unbearably hot, humid Detroit days—so uncomfortable, she wrote to Dad the next day, “that I felt like throwing the dishes out of the window instead of washing them.”

  That was her last letter before Dad’s phone call. After I receive the morning reports and realize that Mom had learned about her husband’s psychiatric evacuation within a few days of her sister’s transfer to the Upper Peninsula, I fish out her letters from late July and read them again, just to make sure that I hadn’t missed anything about Annie.

  I hadn’t. No hint of Annie, no indication of anything unusual taking place.

  Now I knew for sure: If Mom didn’t mention Annie in those letters, when she had specific news to pass along, then she never would. Still, the question remained: Was Annie just a forbidden subject between them, or was Dad truly in the dark?

  I had plenty of news to share with Manny and Shirley: Dad’s psychiatric hospitalization at Darnall, Manny’s presence in Detroit on the very day of Annie’s departure for the Soo, and a breakthrough that tore a permanent hole—in my view, at least—in the greatcoat story.

  Using a genealogy search engine and a Jewish naming dictionary with more variations that I dreamed possible for my grandmother’s first name, I had found what Dad had never been able to give the government during his many wartime applications for citizenship: proof of his entry to the United States. “Chaja” was the key that unlocked the door. That variant for Ida, plus the years 1919 and 1920, brought to the computer screen a list of possible hits that included this one: Chaja Feigel Luksenberg, twenty-eight years old, arriving in 1920 at Ellis Island.

  Luksenberg, not Luxenberg, which is the name on Bubbe Ida’s passport, the one document I have from that era. For months, because of the passport, I had assumed that Luxenberg also had to be the spelling on the passenger manifest. But it appears the ticket-seller had transliterated her name into his own language, Polish most likely, and so she’s Luksenberg when she boards the S.S. Nieuw Amsterdam for the twelve-day voyage, to the former New Amsterdam, aka New York.

  And Dad, the phantom under the greatcoat? He’s right there on the manifest, too, Juda Luksenberg, six years old, no question about it. But one part of the tale turns out to have substance: He spent thirteen days in the Ellis Hospital for some unrecorded illness, thirteen days of anxiety for Bubbe Ida, because not only was her son sick, but it was possible that the authorities would say, sorry, you can’t come in, you can’t join your husband Harry in Detroit, we’re sending you back to Europe.

  In all that confusion, did Bubbe Ida lose the papers? Is that why she didn’t have any when Dad asked her, during the war, to send him any documents that would show how he got here? Bubbe Ida’s not around any longer, so I can’t present her with these new facts to see what she says.

  “Isn’t that something?” Manny says when I call. “A
fter all these years.”

  “Do you think Bubbe Ida made up the greatcoat story, maybe because she felt bad about losing the papers?” I ask.

  “Who knows?” Manny says. “People make up all kinds of things, I guess.”

  That seems like a good transition to Darnall. “Remember Dad’s nervous stomach?” I say. “That really was a cover story.” I briefly tell him about the evacuation to the States, Dad’s eventual transfer to Darnall and his psychiatric diagnosis. When I finish, Manny says, “He faked it.”

  Faked it? That would be a con artist’s triumph. “Why do you say that?” I ask.

  “He would do anything to get out,” Manny says. “He hated being in the Army.”

  I consider that. Dad’s letters certainly show how much he came to despise the Army—he talked about his superiors much the way he would talk about his furniture store bosses later on. Still, I didn’t buy it. I think the Darnall doctors would have their antennas up for outright fakery. Disability wasn’t automatic; while most patients left with discharges, the hospital did send about 15 percent back to duty.

  No, I tell Manny, perhaps Dad took advantage of what happened in Manila, but I don’t think he was faking. He didn’t sound like a con artist in his letters to Mom from Darnall; he sounded like a defeated man who wanted to hide what had happened to him. “Without you my life would be empty. I’d be a total loss–and I’m very thankful that I have you to come home to…”

  I have one last question for him. “Do you remember going to visit Mom just after Mike was born? This would have been July 1945.”

  Now it’s his turn to consider. “Only vaguely,” he finally says. “Why?”

  I tell him that his arrival was on the very day that Annie went to the Soo. “Do you remember Mom saying anything, anything at all, about her family, or family problems? I realize it’s a long time ago.”

  “Too long,” Manny says. “I remember going to see the baby, but that’s about it. The rest of that trip? Just a blur.”

  Why would he have any memory of how Mom was acting? He didn’t have any context for paying attention—just as I didn’t have any memory of Mom doing anything unusual in August 1972, when she managed to take care of Annie’s burial without raising my suspicions, or anyone else’s.

  The mountains of paper on Ed Missavage’s kitchen table look even taller and more formidable than during my last visit. I’m asking him about late 1971, the period just before Annie went to Northville. “I know you never met her,” I say, “but you were there in 1971, so tell me what happened when the transfers began.”

  Missavage delivers his account with equal doses of disapproval and sarcasm. For him, the emptying of Eloise had little to do with patients, and a lot to do with budget-cutters and lawyers who knew almost nothing about mental illness. “Two things were going on,” he says. “First was the move to get patients out of hospitals. The head of mental health in Michigan had a $3 million budget problem. He thought he could find the money by transferring the long-term patients at Eloise, the ones that the state was paying us to take care of, into the vacant beds at state hospitals.”

  I pick up the 1982 Eloise history, which I had brought with me. “There’s a section in here about it,” I say, flipping to a page I had marked with a yellow sticker. I read aloud: “‘Transfer of 900 Patients to State Institutions’…On November 15, 1971, the first 238 patients were transferred, with the indication that the rest would be transferred by June 30, 1973.’”

  I close the book. “That’s a massive number of people to move.”

  He nods. “We sent patients everywhere—to Ypsilanti, Pontiac, Northville. I helped select the male ones, and I sent the best of mine, the least problematic, to Pontiac State Hospital, where my wife worked. It went on for months.”

  Just as Annie didn’t have a say about her commitment to Eloise in 1940, she had no voice in the decision to uproot her from the place where she had lived for thirty years. Unlike the overcrowding crisis that put Annie on a bus to the Soo, however, this upheaval centered on the startling fact that maybe for the first time since the days of Biddy Hughes, the state of Michigan had more beds for the mentally ill than it had patients to fill them. The many competing forces swirling around the country’s mental health edifice had finally collided in 1971, and the impact of that collision reverberated through Michigan’s psychiatric hospitals, the state’s probate courts, and the state’s fledging community mental health system, as well as the wards of Eloise. The expansion that superintendent Thomas Gruber had predicted in 1933 would continue indefinitely? Not just slowed, not just halted, but reversed.

  Like a building imploding, the contraction happened with almost breathtaking speed. In 1955, the country’s public psychiatric hospitals reached their peak of 558,000 residential patients, or 340 for every 100,000 people in the United States; by 1980, despite a nearly 50 percent jump in U.S. population, the number of in-patients had dropped below 120,000, a rate of just fifty per 100,000, an astonishing turnaround that has yet to end. Today, state and county psychiatric hospitals have an estimated total of 50,000 patients; if 1955 rates and policies still applied, there should be nearly one million.

  What happened? In a word, everything. The introduction of antipsychotic drugs altered the very nature of treatment, allowing many patients to go home as long as they “took their meds”; the birth of the antipsychiatry movement called into question the very nature of the asylum approach as well as the very nature of mental illness, even suggesting that mental illness was a myth; the passage of the 1963 federal Community Mental Health Act endorsed alternative settings for treating the mentally ill; the civil rights movement spawned activist lawyers and new legal techniques for challenging the established order; federal and state judges demonstrated a willingness to hear these novel lawsuits, and in some cases, to issue ground-breaking rulings that brought about not just change, but fundamental change. Governors and state legislators, elated at the prospect of reducing costs in a department where expansion had always seemed endless, raised few questions about what the future might hold, although some mental health officials worried aloud about mentally ill patients falling through the cracks of the underfunded and still developing community mental health system.

  In Michigan, Gordon Yudashkin, the director for mental health, saw a short-term solution to the state’s empty wards and his department’s chronic budget problems: reclaiming the state’s patients from Eloise. At one time, at the height of overcrowding in 1945, Eloise would have been delighted to hand over those patients. But now, Eloise needed that reimbursement revenue to stay in business. In the long term, the math didn’t work: Just as the policies of the past had guaranteed the need to build more and more hospitals, the policies of the 1970s guaranteed that Eloise and some state hospitals would eventually close. There just weren’t enough institutionalized patients to go around.

  This time, when Eloise selected several hundred other patients for transfer, no letter accompanied Annie offering assurances of her ability to “take care of herself.” When she arrived at Northville on January 4, 1972, she was only fifty-three years old, but she brought with her a host of physical problems and medications—a worsening heart condition treated with daily doses of digoxin, a fluid buildup that required a diuretic to control, and a series of recent vomiting episodes that the nursing staff at Eloise had thought significant enough to note in her medical chart. She remained on her usual regimen of Serentil, an antipsychotic, and Artane, a drug used to combat the Parkinson’s-like symptoms that often afflict patients on antipsychotic medication for an extended time.

  What would become of her? That was entirely up to the Northville staff. Annie could hardly speak for herself at this point. As the Northville records stated, “At the present time she remains being incoherent and irrelevant most of the time but has been no real ward problem. She tries to cooperate with the staff as best as she can and follows instructions much better. The team feels that her condition has stabilized and that she could be
taken care of in a nursing home.”

  The next day, she was transferred again, for the last time, to Petoskey Hall, a nursing home run by a private group that, only months before, had acquired the property from the Jewish Home for the Aged. In one sense, she was going home. Petoskey Hall was just two miles from the apartment on West Euclid where she had lived before her commitment to Eloise. In a more realistic sense, she was going nowhere, to a place where she knew no one and no one knew her. When she died eleven weeks later of a stroke, a doctor at Northville took the call from the nursing home and added a terse note to her chart: “At this time we are not able to obtain any further information regarding this patient or the cause of death.”

  That’s the final sentence, the last words, an ending without a conclusion.

  Lawsuits against mental hospitals spread like wisteria through the nation’s federal court system in the early 1970s. Eloise’s turn came in 1971, when Gabe Kaimowitz, a young lawyer at the Michigan Legal Services office, took a call from twenty-four-year-old Annette Bell, confined at Eloise on a temporary involuntary commitment that had been extended twice. The clock stood at seventy-five days, and ticking. Bell wanted out.

  Although much had changed in the mental health world since Annie’s commitment in 1940, not much had changed in probate court procedures. As in Annie’s case, two Eloise doctors had certified Bell as mentally ill and in need of “treatment.” As in Annie’s case, they declared that it would be “improper and unsafe” for Bell to attend her own hearing. As in Annie’s case, the probate court judge had complied with Eloise’s request to keep Bell at the hospital without a full hearing or the taking of any other testimony.

 

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