Saint Elizabeths

We took a group of students to perform excerpts from our school musical for patients in the criminal ward of St. Elizabeths Hospital (in Anacostia) on Tuesday. As you can imagine, this is one of the more unusual performing situations I have found myself in, but everyone involved thought this was an uplifting experience. The patients, many of whom never leave the hospital building, are always glad to have the opportunity to hear music, and sadly too few of the organizations who might be able to bring music or other performances to them have the guts to carry through and do it. If any readers work in schools in the Washington area, a visit to the hospital is a great opportunity for students to perform a worthy community service. The staff are welcoming and extremely supportive, and there was never any feeling of insecurity on the part of any student.

Saint Elizabeths is one of the oldest hospitals in the District of Columbia, founded by Dorothea Dix in 1855 as the Government Hospital for the Insane, a place to treat and rehabilitate soldiers and sailors and other residents of the nation's capital. The oldest building (Center Building, designed in the Gothic revival style by Thomas U. Walter, who also designed the dome of the U.S. Capitol) was apparently constructed mostly by slaves (see image at left), and it is no longer used (along with most of the western side of the hospital grounds) because it is in such terrible disrepair. (You can see the revolting state of deterioriation in this slide show of images put together by the local NBC television station.) The hospital's history as the only real national center of psychiatric medicine was cut short under President Reagan. Since the District of Columbia took over the operations of Saint Elizabeths in 1987, the vast majority of patients have been released or moved. Now only about 600 remain, and most of them live in a building called John Howard Pavilion, where we gave our performance.

The decline that has been allowed at Saint Elizabeths is bad not only for the patients but also for the American national patrimony (yes, I think we have one of those). The hospital's historic buildings and grounds were on the 2002 list of the 11 Most Endangered Places put together by the National Trust for Historic Preservation, as well as the 2003 list from the D.C. Preservation League. Many veterans of the Civil War were treated there, some of whom are buried in a cemetery on the grounds (see picture here). (Saint Elizabeths was the colonial name for the land given to the hospital, so the soldiers who were patients there began to call it by that name, which the hospital finally adopted as its official name.) The hospital is back in the news these days because its most famous patient, John Hinckley (committed in 1982 after shooting President Reagan), has been trying to convince a judge to allow him to leave the hospital on unsupervised visits to his parents' home (see this article from ABC News, this article in the Washington Post, and this article in the New York Times). The hospital and Hinckley's doctors support the request, but the families of his victims do not. (Mr. Hinckley was present at the end of our performance at the hospital.) As it turns out, the first attempted presidential assassin, Richard Lawrence, who tried to shoot President Andrew Jackson at the U.S. Capitol in 1835, was declared insane and ended up spending the last five years of his life at Saint Elizabeths.

There are many other important historical notes related to Saint Elizabeths. All sorts of innovative treatments were developed and used in the hospital, including hydrotherapy, Freudian psychoanalytic techniques, dance therapy, psychodrama, and the use of artistic creation as a therapeutic release (see this fascinating article on a piece of lace created by a patient at Saint Elizabeths in 1917). In the 1940s and 50s, the director of laboratories at Saint Elizabeths was Walter Freeman, who with his colleague James Watts was a pioneer and advocate of now-controversial procedures like the lobotomy, insulin shock therapy, and electroconvulsive therapy. (Dr. Freeman's most famous patient is probably Rosemary Kennedy, sister of President Kennedy, who was lobotomized in 1941 with sadly disastrous consequences. However, William Alanson White, superintendent of Saint Elizabeths at the time, did not allow lobotomies to take place in the hospital. Dr. Freeman performed them as part of his private practice.) The poet Ezra Pound, accused of treason because of anti-American statements he made on Italian radio during World War II, was a patient from 1945 to 1958, in the care of Dr. Winfred Overholser. The site was chosen for its access to what is supposedly the best view of the federal center of Washington, D.C. (from a vantage point known as "The Point"), a vista thought to have been beneficial to the recovery of patients. Trees of many unusual species were brought from around the world in the 19th century to adorn the grounds.

Autopsies were routinely done on the hospital's patients, and the large number of samples of brain tissue collected at the library was donated by Saint Elizabeths to the National Museum of Health and Medicine (the so-called Blackburn-Neumann Collection can be consulted there; the NMHM is part of the Armed Forces Institute of Pathology at Walter Reed Army Medical Center). It is estimated that the hospital has treated about 125,000 patients, and significant numbers of them may be buried on the hospital grounds (burial records were kept poorly and may now be lost). This makes any discussion of development of the site quite problematic and requires historic preservation with even greater urgency.