"An Evaluation of the Work Done on Ward 41"

Excerpts from "An Evaluation of the Work Done on Ward 41 Edgewood Service at Hudson River State Hospital," by J. Willard Linscheid:

"Ward 41 is the largest of the wards with a patient census varying between 110 and 12 men…The patients were all destructive, incontinent, feeble or occasionally assaultive. A number were blind and crippled. Their diagnoses varied, including seniles, general paretics and the dementia praecox types. There were no working patients capable of taking more than a very negligible amount of responsibility…Because of the lack of good worker patients and attendant help, it was impossible for one attendant to keep the room clean and so most of the time feces and urine puddles were in evidence…"

"Meals were served in three shifts. First those who were capable of carrying their own trays from the counter came in. Then three tables were set for the assaultive and destructive patients who had to be watched closely and even then would steal food and upset trays. The last troupe fed were the blind, crippled, and feeble. When we arrived the system had been to serve the blind and feeble first. This was usually accomplished in ten minutes or less. The attendant would wait until about half the group was out and then begin jerking the trays away from the others to hurry them out. If a patient protested he was forced roughly from the room. Little attempt was made to check if all the patients had been served and often some were deliberately not called either for punishment or because they were ‘too much trouble to feed.’"

"Because of the large number of incontinent and destructive patients, much clothing was destroyed and soiled so that much of the time the disturbed patients in the small day room were entirely naked. At night the patients were put to bed with their clothes on and so much was ruined before morning. Because of the wartime shortage of sheets and blankets the majority of patients had only one sheet or one blanket on their beds most of the time. If possible the disturbed and incontinent patients were also given a blanket or sheet but much of the time they slept naked and uncovered on the hard canvas mattresses."

"Attempts at improvement: We attempted to right some of the many wrongs. Our first move was to shower the soiled patients when necessary. This only increased the lack of clothing and they were naked as often as before. To partially remedy this, two men were put on a 10:00 a.m. to 7:00 p.m. shift. It was their job to undress all the patients, tie and label the clothing of the cleaner ones and sort the clothing of the incontinents. This helped somewhat in keeping at least the cleaner patients clothed."

"In the cafeteria we changed the order of groups so that the feeble and blind were served last and no patient was forced to leave the dining hall before he completed his meal. We also saw to it that every patient was served all three meals…Our efforts were concentrated on giving better and kinder treatment to the patients and to keep the ward as clean as possible under the circumstances…"

"Attendant reaction: Working a ward such as this one with negligible patient help, almost no supplies, and very poor facilities in general is quite a strain on an attendant…When it is impossible to do more than clean  the most obvious dirt and possibly only to keep the patients as well in order as possible, a kind of lethargy sets in."

"I’m sure we all chafed under this necessity of giving only custodial care and we were all keenly aware of the improvements that could be instituted with more attendant help, more supplies and better facilities…I feel that our most important contribution was in giving more individual care to all the patients and treating them all in a more gentle and humane fashion…This contact with abnormal individuals gave us all a deeper understanding of society in general and of the evils rampant in the world today. Our relationships with patients’ relatives gave rise to feelings of sympathy and again to feelings of anger and helplessness when we realized our own inability to explain behavior causes and to accomplish any evident improvements in these patients’ behavior.

"I think we were all fired with a desire to expose mental hospital conditions to the general public in the hope that such an expose would lead to action toward the improvement of such institutions. Certainly to work for any length of time on such a ward as 41 a person must either agitate for betterment or sear his conscience entirely to the ills of humanity.”

--Taken from Melvin Gingerich, Service for Peace: A History of Mennonite Civilian Public Service. Akron, PA: Mennonite Central Committee printed by Herald Press, Scottdale, PA, 1949. p243-6.