Madness, Antonia Hylton, author and narrator
This is a heart-wrenching book about the failure of society to properly care for people in the black community. As it raises the specter of Henrietta Lacks, at the end, the reader knows that the failures are pervasive, not just in the area of mental illness, but in all areas of medical treatment. The author based her book largely on the oral history of those relatives or friends of former patients of the Crownsville State Hospital. Little written history was discovered, perhaps because these people were treated so poorly that few wanted any records to survive.
This book reveals the mistreatment of the patients at Crownsville Hospital, in Annapolis, Maryland, where in addition to not being properly treated, the patients were exploited and actually kept, not as patients, but as prisoners in order to provide cheap labor for the community, in another iteration of slavery. Even though many were mentally fit and could have been returned to society, they were kept there and put to work. The women were often farmed out as domestics. The patients were unpaid. However, the hospital received remuneration and did not want to give up the income.
As the history of the hospital unfolds, the reader witnesses the lack of care, the inadequacy of the laws providing separate but equal facilities which were never equal, and the futility of such ridiculous laws, as well. However, the author stresses the fact that the black population would like to be treated by people that look like them, that better understood their concerns and problems, and I am forced to wonder if the white population insisted on that, how would it be viewed? Be that as it may, equal facilities that treat all people with the same level of care are what we should strive for at all times. No one should die or suffer because of race or religion or sexual identification. All people deserve the same level of care and compassion. Self-segregation may exacerbate the problem of attaining equality.
In the Crownsville State Hospital for the mentally impaired, often the patients were remanded there as punishment for breaking the law, rather than because of an infirmity. In hospitals that treated white patients, the conditions were different, though not always better, as the movie “The Snake Pit” revealed. However, this hospital, Crownsville, for black patients, is the only one in the recorded history discovered by the author, that was built by the actual patients, which definitely calls into question whether or not they actually belonged in a locked facility.
The book illustrates the high incidence of depression that was ignored in the black community, and was instead treated as a more serious, difficult to cure mental disorder. The patients were subjected to experimental treatments without their permission, some of which were violent abuses of the body and were often performed without appropriate approvals, like lobotomies, shock treatments and others that were more like torture than treatment. Henrietta Lacks, the black woman mentioned above, whose DNA saved many lives, lost her own to the lack of care she received. Her daughter, a patient at the hospital was also treated without permission and died at a very young age, while still a teenager, after possibly suffering from painful treatments without approvals. The lives of these patients seemed to be viewed as easily discarded, and their graves wherever they were, were unmarked. The author notes that some may be under the concrete of a parking lot today, which is an incredible expression of disrespect for the person’s death. Families brought their relatives there willingly when they could no longer cope with them, yet they probably knew they might never see them again.
It was the staff of color, largely, when finally able to get the education to enable them to work in the hospitals to help care for the patients, that discovered and exposed the abuses that were occurring in this facility and others. Children and adults were housed in the same facility until they were sent to Rosewood, but the location often made it impossible for family to visit, fixing one problem but creating another. Some of the staff members even took in some vulnerable teens, and cared for them, sending them to school and showing them compassion which often helped them to heal. They could shower, not have a bucket of soapy water tossed at them which passed for a shower. The filth of waste in the halls disappeared, as well. Often, teens were rounded up and brought to the hospital against their will because they were loitering. They would have felt helpless and lost. They were only in the hospital because they wanted to feel they fit in and belonged someplace. Some, therefore, recovered. It seems, as the book reveals, the youth in the community were often so depressed that their behavior brought about an extraordinary number of their deaths, due to unawareness, neglect and improper treatment.
Eventually, all of these facilities were closed down because of abuses and improper care. However, appropriate places to continue care were not provided, resulting in many homeless and disorderly people that are now arrested for crimes, filling up our prisons, instead of providing the appropriate care for whatever disorder they suffer. Reading about the abuses that were so rampant and so easily ignored and/or accepted, I wondered if the doctors and nurses working in these kinds of facilities needed to heal themselves first, since some of their behavior seemed extraordinarily cruel and thoughtless.
The author worries about her own genetic history and hopes that she will understand, if and when she is afflicted with a disorder, so that she is able to get the appropriate responsible level of care. I was a bit flummoxed by the idea that the hospital had such an awful reputation and yet often the families still brought their relatives there, knowing they would never leave. Were they just so unable to care for the person themselves that they felt they had no other choice? I had to remind myself that when this hospital was built and flourished, it was a time when neither Jews nor Blacks were welcomed into a community. Today, it is hard to believe that the bias still exists and has been in the forefront of the news. Still, it has once again reared its head regarding the Israel/Gaza war and a recent event on the subway involving a former Marine who is being called a murderer by the black community and a hero in the white community. He stepped in to help when a black man with mental disorders harassed and frightened the people in a NYC subway car, a subway that had been plagued by recent criminal violence. The black community believes he was murdered intentionally, the white community believes Penny was trying to help. The passengers were trapped and terrified. They felt threatened. They were there. The author was not. The man posed a threat to them. No one knew what he was capable of, and surely, Penny did not intend for him to die. Instead of choosing sides, the person in question should not have been unsupervised in society, and he should have been receiving care and guidance from his own family and the medical world. He had a history of arrests for assault, so surely, he could have presented a far greater danger than the black community is admitting. That is the problem society is facing. The eyes of the beholder see different things. There is no place for the unwanted in society, regardless of the color or religion. Unfortunately, society has not progressed far enough, but we must all deal with the cracks in our foundation and deal with each incident in the same way, with fairness and an equal hand of justice. ( )

A Harrowing Account of the Overlap of Two Forgotten Groups in American History

Journalist Antonia Hylton weaves together first-hand accounts and oral history (including her family's and her own) and what documentary evidence is available to tell the story of Crownsville Hospital - originally Maryland's Hospital for the Negro Insane - in Anne Arundel County from its opening in 1911 through its integration in the decades after World War II until its eventual closure for lack of funding in 2004, and what has happened since with the grounds and some of the final patients. I have a special personal interest in the history of American mental institutions due to my grandmother, who was institutionalized in the early 1950s in deplorable conditions. My grandmother was a White woman living in Indiana. Until I read Hilton's book, I could only imagine how much worse it could have been if she were Black and living south of the Mason-Dixon Line. Hilton's case study of American mental health treatment touches on the insanity of daily life first under slavery and then Jim Crow, and the impacts of institutional racism and lack of adequate mental health care on America's modern economic disparities, gun violence and incarceration rates. As a laser-focused stand-alone, it is compelling, but it leaves the reader wishing it could be the companion piece to a documentary film, or better yet, the launching point for a more comprehensive history. ( )

Madness: Race and Insanity in a Jim Crow Asylum grabbed me from the synopsis to the last page of the book. It tells the heartbreaking story of Black men, women and children who were exploited and intentionally abused, all for the sake of gaining free labor, starting with the 12 Black men who cleared the land and built it under the supervision of a doctor. Once done, they became the first “patients” at the very institution they helped to create. The patient population grew by leaps and bounds, and there was shockingly little to no care given to them; the majority barely had a bed to sleep in, food to eat, clothes to wear. I was beyond saddened and angry to see that they basically devised a way to “rent” out the “patients” to other businesses, giving them absolutely none of the so-called help they claimed they needed. There were parts of this book that tore at my emotions, had me crying for those who suffered unbearably. This is the must-read book of the year; it’s written with such flowing description it almost makes you feel as if you’re right there. ( )