February 19, 1969
(Prologue)

*

Caged.

I was caged.

Then, I was driven.

Driven to Cherokee.

A hazy memory of riding caged in the back of a police car.

Two shadows in the front seat, the county sheriff and a female escort.

Patsy Cline’s “Crazy” buzzing from a tinny transistor radio.

Outside, the Iowa landscape bleak.

Cloudy and cold.

Condensation and frost riming the windows.

Piles of dirty snow dotting the countryside.

I, cargo.

Destination: Cherokee’s other place, the outline on the hill.

Shifting, crossing my legs…

Please, can we stop?

Hot and steamy inside.

Shivering, my teeth rattling.

Please…I have to go!

Hear something, George?

Naw, nothin’ important.


Laughter.

Cargo has no voice.

Madness has no voice.

Listen, crazy girl…

Two voices: We have come to take you away, ha, ha…

“I’m crazy, crazy…”

Fragments, crazy-quilt impressions, acid flashbacks…

I, crazy?

Tuesday, December 2, 2008

Epilogue: A Short History of The Cherokee Mental Health Institute

*
Summer 2008

(York, Pennsylvania)

In late September 2004, I gathered my laptop, notes, photocopies of old letters to and from my ex-husband, Cherokee Mental Health: 100 Years of Serving Iowan’s (Cherokee centennial book), maps of Iowa and Cherokee, and the August 30 issue of the Chronicle Times. I carried them to Skopje, Macedonia, where I spent October 2004-May 2005 cranking out a 700-page draft.

A stranger in a strange land attempting to codify an unresolved past. Still, writing that first draft was exhilarating: I had few distractions: for eight solid months, I simply wrote.

Often tapping away eight hours a day, five days a week, I became 18 again, an odd space for a 21st century baby boomer.

Not only did old issues and angers rise up again, but after rereading my ex-husband’s letters, I even developed a slight (albeit temporary) crush on him--also compounded by the impending birth of our granddaughter Rhia, born late 2004.

Since my July 2005 return to the U.S., the revision process has presented a rockier road, ordinary life often interfering and my trying to decide what to delete and add. Because this is my story, every detail seems important, so deleting has often been problematic.

A short history of the Cherokee Mental Health Institute does feel like an important aspect of my story, but it seemed out of place in the main narrative thread, so I moved it to the end of the book and here on this blog.

*

The exterior of the Cherokee Mental Health Institute does not resemble a state hospital.

The grounds, on a gentle slope leading up to the main buildings, are stunning and kept pristine by the grounds keepers and not walled or gated from the community. In summer, a lush greenery dominates--the carpet grass is cut and watered regularly, and several varieties of trees, including conifers and deciduous types, majestically dot the landscape. Iowa trees in general tend to be sparse and scrubby, so these grounds offer an oasis, a gift to Sioux Valley Iowans, perhaps explaining their broad appeal to the community, who often use the roads as hiking trails.

The buildings are over 100 years old, some of them resembling red stone and brick castles, with spires and circular annexes, but in good exterior condition.

If there is anything forbidding about the place, it can be found in its history and my commitment there. According to Cherokee Mental Health: 100 Years of Serving Iowan’s, the institution was founded in 1902 as the “Cherokee State Hospital for the Insane.” It is not a stretch, then, to view the long shadows cast by the trees and spires as sinister. Also, the red brick portion is somewhat an anomaly in Iowa, not indigenous to this area, known more for its black, loamy earth.

The facility resembles a private secondary school or even a college campus, except for one section, now used as a sex offender unit and housing 35-80 inmates. According to a Department of Human Services press release from Governor Thomas J. Vilsack’s office, the Civil Commitment Unit for Sexual Offenders (CCUSO), dedicated on September 8, 2003, has been designed to treat “dangerous sexual offenders.”

“The litmus test for everything we do is safety,” said Kevin Concannon, Director of the Iowa Department of Human Services. “We’ve gone the extra mile to make sure this facility is safe for patients, safe for staff, and safe for the community.”

CCUSO is housed in a remodeled wing of the institution, the sex offenders having “no contact with patients at the mental health institute.” The section does resemble a maximum security prison, cordoned off with steel fences and barbed and razor wire, incorporating “security cameras and locks,” and mandating “special training for security personnel.”

At 18, I would have been upset about having a sex offender unit housed on the same grounds. Safety is a relative term, “safety and sex offenders” an oxymoron, no matter how many security cameras, bars, locked doors, and razor wire used. In a 2005 blurb on Online Highways, the sex offender unit is not mentioned:

The Cherokee Mental Health Institute (MHI) is a state of Iowa psychiatric facility, operating under the Department of Human Services. The institute provides psychiatric inpatient and outpatient services. Forty-one counties in northwest Iowa are served for adult patients and fifty-five counties for children and adolescents.

The MHI is proud of its campus, The Cherokee Human Resource Center offers patients, as well as the Cherokee community, access to a hiking trail and nature study. In addition to the MHI, the campus is also home to other agencies including Synergy (Chemical Dependency) Center, The Boys’ and Girls’ Home, the YES (Youth Emergency Services) Center, Job Service of Iowa, Vocational Rehabilitation, Juvenile Court Services, and the Ecumenical Institute.
Traditional psychiatric inpatient admissions have dwindled since involuntary commitment of patients for frivolous reasons was struck down by two significant Supreme Court decisions: Humphrey v. Cady, 405 U.S. 504, 509 (1972), which ruled involuntary civil commitment to a mental institution as “a massive curtailment to liberty,” and O’Connor v. Donaldson, 422 U.S. 563, 574 (1975), which ruled that there is “no Constitutional basis for confining such [mentally ill] persons involuntarily if they are dangerous to no one and can live safely in freedom” and that the presence of mental illness “does not disqualify a person from preferring his home to the comforts of an institution.”

Evidently, incorrigible minors at Cherokee are still not accorded the same rights as adults. A May 10, 2002 Des Moines Register article reveals that

An 11-year-old boy with extreme behavioral problems is subjected to enemas, made to wear diapers and forbidden to bathe at the DHS-run Cherokee Mental Health Institute until a judge orders the procedure halted. DHS promises an investigation into the boy’s treatment. Another state agency later finds that the DHS staff implemented treatments that were “conducted in accordance with doctor’s orders.”

(For more info, click here).
Fortunately, I wasn’t incorrigible enough to be subjected to such indignities.

At the time of my involuntary commitment, my only protection was the Supreme Court decision Specht v. Patterson, 386 U.S. 605, 608 (1967), which offered legal protection at the mercy of the court system itself: “...involuntary commitment to a mental hospital, like involuntary confinement of an individual for any reason, is a deprivation of liberty which the State cannot accomplish without due process of law.” Even a neophyte can see how a lower court could (and did) interpret that decision; my court record speaks for itself.

Back in 1969, I met some the employees, many of them dedicated to serving Iowans. But Cherokee owns a sad history of warehousing the mentally ill, the incompetent, and the incorrigible. Before the two important Supreme Court decisions, people not fitting into conventional boxes prescribed by the dominant culture were often punished and hidden away.

Forgotten.

Cherokee itself simply fulfilled a mandate created by an antiquated judicial system mired in nineteenth-century wild west justice.

My residual anger lies with Woodbury County, Iowa, and the police officers, lawyers, judges, and doctors who pushed through sloppily prepared paperwork and trumped up reasons without considering a person’s constitutional rights.

I came out of my experience fairly well-adjusted, though my “inclination to conflict with social convention,” as predicted by R. Lowenberg, has persisted, for I have always believed that so-called conventional wisdom is vastly overrated. Ralph Waldo Emerson articulated the herd mentality best: “A foolish consistency is the hobgoblin of little minds.” The world needs people who would flout conventional wisdom, not warehouse and silence them.

The Cherokee book does offer some interesting history about the institution’s origins. The first superintendent, Mathew Nelson Voldeng, M.D., was hired in 1902--his beginning salary $250.00 a month. He served from 1902 to 1915 and died in 1934.

One would not suspect Cherokee as being a hotbed of feminism, but, surprisingly, Iowa’s first female physician, Dr. Lena Beach, served there, starting in 1902, for which she was paid, as Woman Physician, $100.00 a month, less than the 1st and 2nd Assistant Physicians (presumably men), who were paid $133.33 and $116.66 respectively, but more than the 3rd Assistant Physician, paid $91.66. Somewhere, there exists a biography of Dr. Beach, this pioneer spirit who started the wheels of women’s rights rolling in Iowa.

In the early years, many of the staff lived on the campus; however, children were not allowed. Children born to employees were “farmed out to foster homes within the community to be raised.”

Now that’s workplace loyalty.

The first eight Cherokee patients were admitted between August 15 and August 26, 1902. In late August 1902, 563 patients arrived via two trains: 310 from Independence and 253 from Clarinda. In Independence, curious citizens looked on as the stronger patients walked two miles from the hospital and the weak and sickly were transported by trolleys or hay wagons to the Cherokee train. According to the 29 August 1902 Cherokee newspaper, Clarinda offered a higher class of patient: “better dressed, better behaved and showed a little more intelligence.” More patients, 777 from Clarinda and 144 from Mt. Pleasant, were expected in the next few days.

Between 1933 and 1951, Cherokee boarded over 1,400 patients. At its peak, the institution housed over 1,700--no date is given for this number, but with the 1954 introduction of Thorazine, patient population began declining. The book offers no figures for 1969, but the population must have still been fairly substantial, for most of us had roommates.

Throughout the years, patients have been subjected to insulin and electric shock therapies, integral parts of Joyce’s treatment [Joyce was another patient whose name, in this memoir, has been changed].

Straitjackets were discontinued in the early 1950's, but lobotomies were performed into the early 1970's. Had I known what a lobotomy entailed, I would have been terrified that if I didn’t behave, the procedure would be in my future. However, lobotomies were done as a last resort, reserved for the most violent patients. To my knowledge, I did not meet any lobotomy patients at Cherokee, but, at that time, I would not have been cognizant of their characteristics. I suspect that these patients were kept segregated from the general population.

Years later, I met a person who had endured a lobotomy; it was frightening to witness the damage done to him. He would simply turn on and off like a light switch, talking one minute and then drifting off into some kind of trance and then coming back, picking up exactly where he had left off.

During World War II, from February 1944 to May 1946, the Civilian Public Service Company #131, made up of conscientious objectors, served at the facility in lieu of military service. This company consisted of 25 conscientious objectors, 10 of their wives, and one sister. They served as nurses’ aides, kitchen workers, drivers, lawn and garden assistants, housekeepers, and stenographers. I would have appreciated knowing this bit of history, given my own objection to the Vietnam war and my fears for Jeff [Brown, my ex-husband] and my cousin Steve.

At its peak, the hospital, on its 840 acres on the hill was, in itself, a small functioning town, boasting its own coal-burning power plant; a complete working farm; hospital facilities, including a dentist’s office, lab, geriatric ward, and morgue; a cemetery; a full restaurant; a butcher shop; laundry facilities; residences; carpenter and machine shops; a sewing factory; a bakery; an “amusement hall” and orchestra, made up of staff, who were often “hired on their ability to play an instrument”; a softball team; a pharmacy; and a barber and beauty shop.

Certainly, if the rest of the world disappeared, the institution could have survived, taking care of its patients and following the standard drug and psychological therapies.

The book does clarify one matter that, for years, has puzzled me: in April 1969, I spoke with a Mrs. Williams about job training in Floriculture; I could never figure out why she was pushing this career so hard, but the book reveals that Cherokee, in addition to its working farm, complete with vegetable fields, flower gardens, orchards, and beef and dairy cattle, also maintained an extensive greenhouse, overlooking the southeast section of the grounds, where the institution grew flowers and vegetables year round, even exhibiting some of their products at various state fairs.

I don’t remember seeing or even hearing about this greenhouse, but I might have embarked on a career because of its existence.

At various points in its history, several other training programs were offered to patients: bakery and butcher schools, to name two, and a physician residency program, for doctors just out of medical school. Currently, the facility offers a physician assistant specialty training program.

I complained bitterly about the food; in my mind, a good Cherokee meal consisted of roast beef, mashed potatoes and gravy, and peach cobbler, reserved for Sunday dinner. However, most of the time, we were served such delights as instant scrambled eggs (with a green tinge), overcooked vegetables (mushy cauliflower comes to mind), a strange meat--which I suspected was liver--and wicked coffee, often served lukewarm, so I was surprised to read about the T-bone steaks and oyster stew served during the 1960's. I don’t recall such meals, but I do remember losing a lot of weight there.

One odd, though darkly humorous, note: 100 years ago one group of female Cherokee sewing factory workers were scrutinized very carefully, for “...some medical authorities warned that professional seamstresses were apt to become sexually aroused by the steady rhythm, hour after hour, of the sewing machine’s foot pedals.”

Had I known that, I would have happily taken up sewing as a career path, but then the next part of this equation might have given me pause: “[These same medical authorities] recommended slipping bromide--which was thought to diminish sexual desire--into the women’s drinking water.” [In response to this “minor” reference to these women who were so cruelly treated, I was inspired to write a poem and an essay in honor of them.]

The hospital also had its own morgue, but this building was torn down in 1966, well before my time as a patient. Interestingly, the morgue was located near the Kinne Building, demolished in 1972, where the tuberculosis patients were kept. The morgue may have disappeared, but a cemetery remains on the grounds--831 patients interred between 1907 and 1962, the last a 62-year-old woman. The deceased, unclaimed by family members, were placed in wicker baskets in graves marked with numbers, for being a mental patient was considered too shameful to be made public, even after death. I never saw or heard about this cemetery--and D.J., a patient who had worked on the grounds, never mentioned it.

Back in 1969, I knew nothing about the morgue and cemetery, but I must have suspected something; on April 11, after recounting a frightening nightmare I had at age four, I asked, “I wonder if anyone has ever died here?” I’m glad I didn’t know; I was frightened enough about the possibility of being incarcerated for a long time and then dying in the institution.

Chronicle-Times (Cherokee) journalist Ken Ross noted that “The cemetery is down a road beyond a locked gate. Trees surround the cemetery and Beacon Hollow Creek runs nearby.” So I wouldn’t have stumbled upon it during my walks.

In 2001, as mental illness became less of an embarrassing secret and more visitors asked to see the cemetery, the institution decided to create a memorial and formed a committee to plan the cemetery reconstruction, offering a dignified resting place for the 831 patients. In the past, when descendants visited the graveyard grounds, they were disappointed. “We were apologetic about the condition of our cemetery,” said Mike Thompson, plant manager for the institution. The project was completed in 2002 and slated for dedication in time for Cherokee’s 100th anniversary celebration on August 15, 2002, denoting the 1902 arrival of the first patient.

I don’t know how much Cherokee Mental Health: 100 Years of Serving Iowan’s really explains in terms of my time in Cherokee, but it does reveal some of the ingrained attitudes toward mental patients that still persisted in 1969. I would have liked more information about the history of the institution, including the subsequent superintendents, psychiatrists, and psychologists who practiced there, and more detail about the therapies, but confidentiality issues might have hampered the committee charged with pulling this history together.

Perhaps my story will reveal something important about Cherokee and other similar state hospitals.

____________________________________________________________________

Source: The CMHI Centennial Committee. Cherokee Mental Health: 100 Years of Serving Iowan’s. A Pictorial History. Iowa Department of General Services Printing Division, November 2001.
*

17 comments:

  1. Seriously? What were you on that made you so delusional while there? The things you claim to be true here, clearly are from your imagination...........or shall I say your schizophrenic mind?

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    1. I was in Cherokee MHI in 1986-87 at 16 years old and it was not a very nice place even then. I was forced to do things and have procedures done that had nothing to do with my reason for being there. I was put in a restraint chair for hours for simply stating my feelings and then taken to south 7 for 24 hours. I remember being told by staff that back in the 6o's women patients were raped in the tunnels between the main building and Donohue building by male psych patients that got loose. You're inconsiderate to put it nicely! You don't even know this person and you're calling them delusional and schizophrenic! Who do you think you are? Have you been there? Were you a patient? Or one of the staff that mistreated patients and have no right being employed at such a facility?!

      Delete
    2. You obviously don't even have the guts to use your name "Anonymous"

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  2. I normally don't subscribe to anonymous comments from people who hide behind anonymous walls, but I have made an exception here.

    You should know that much of my research (at least for this particular post) came from a booklet published by, guess who? The Cherokee Mental Health Institute:

    _Cherokee Mental Health: 100 Years of Serving Iowan's_

    As for the rest, well, my experience is my experience, and it is what is it.

    If you have your own experiences with Cherokee, I'd be glad to hear it--just post it here.

    Cheers!

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  3. I can assure you that the inmates of the CCUSO unit aren't getting out any time soon. I am a resident of Cherokee and have a long history of family members working at the institution. Sometime you take a look at the museum there. Also you forgot that the institution was a leader in the practice of lobotomy.

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  4. My mom was a "patient" there during the 60s. I think it's safe to say she was saner going in then. Coming out. That place emotionally scared her and I had to grow up with those scares. You should hear some of the stories she tells about that place. To bad it's still open bc it was and Probley still is a hell hole.

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  5. My mom went into Cherokee in the Autumn of 1968, I was 13 and essentially orphaned by her mental illness. I lived with an older brother during that nearly year long hospitalization, and we'd travel from western South Dakota (where he was a teacher) about once every 2-3 weeks to visit mom. She was indeed struggling psychologically, a combination of stresses including the death in-the-line-of-duty of my dad. While there she was twice given courses of ECT (shock treatment), although ECT is not now or then considered a first-line treatment for depression. Interestingly, when she was finally discharged she left with a diagnosis of schizophrenia, and medications for schizophrenia. ECT is not used to treat schizophrenia. I remember vividly arriving for a visit, no one told my brother or I that mom had just had a session of ECT. When we reached her on the unit, she did not know who either of us were...as memory is totally gone immediately following a session. Imagine, Anonymous, what it was like for a 13 year old kid to encounter that situation, and how clueless the staff at Cherokee must have been to allow such a visit to happen without one word of warning/explanation. My mom never did recover from her "treatment" at Cherokee, she never again lived independently, but was the inspiration for my career as a psychologist, my brother's career as a psychologist, and two nephews careers in psychology and psychiatry. Each one of us home our work helps others to recover, rather than assuming mental illness is a terminal condition.

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  6. Thanks, FreeThought, for your comment. It seems as though mental institutions are not all that great for patients.

    Ironically, Cherokee is probably one of the better state hospitals.

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  7. I am not only a resident of Cherokee, but I have voluntarily committed myself to MHI once, know many people who work there and fully support what they do there. I live with, not suffer from many different mental illnesses, including Bipolar Disorder, ADHD, Borderline Personality Disorder and Depression. I have done a lot of research on MHI, been to the museum, talked to many of the workers and help bring awareness to mental illness. Yes, things have changed over the years when it comes to treatments for those with mental illness and not all blame can be placed on one or all institutes as no one then or even now can understand what it is that someone with a mental illness goes through in their head. It is not an illness that can be seen, touched, or even explained...so how can proper treatments then or even now be right or wrong? I feel the pain so deeply for those who experienced the horrific treatments in the past and know full well if I was alive then, I would have had the same treatments. What you have here is the truth as not only the source is valid, but it is widely known of MHI. The doctor who was the creator of the lobotomy came to MHI to demonstrate how to perform the procedure and got caught up in taking publicity photos while doing it and killed not one but two patients. He then left. (This was just told to me by the curator of the museum) Although i personally hate the fact that CCUSO is there but that is due to my own personal experience with a sexual predator as a child in another state. Since my stay there, I have got control over my illness/mental state and live a productive life. I am attending school and have taken many psychology classes to also help understand mental illness even more. As I stated before, the history of the treatment of mental illness is horrifying and injust all due to the lack of knowledge. I deeply feel for anyone who suffered in those times. Thankfully times have changed and so have the treatments. This is not the day of Sigmund Freud thank god. As of now and in my honest opinion, the Cherokee Mental Health Institute is a better place than those I have been to in the past. Bless your heart and to those who were tortured there and in many other places in the past.

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  8. Thank you, Kymberlee Jean.

    Your experience shows that there are two sides to every story. And it's true that medical science has improved life for mentally ill people, though it's still a struggle for many.

    There are wonderful people who worked and still work at Cherokee. and I commend them.

    ;=)

    Thank you!

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  9. Jennifer, I have been reading your very interesting & informative blog. The reader comments are also very enlightening.

    I am a retired Fire Capt Atlanta FD. I search for, and research missing/murdered cases. The purpose of my post is in search of info on a patient that was sent to Cherokee MHC/IA in 1986/87.
    Did you know him, or of him? Any info that you can provide on Michael J Klunder; child sexual predator, would be deeply appreciated. He was 6'6" & over 200 Lbs and would have stood out in a crowd.

    Also any info pertaining to Bremwood (a juvenile home) in Waverly(Bremer Co)IA. Specifically; did the juveniles maintain the grounds & picnic areas at the 7 Bridges Park Wildlife Area. Bremwood was a Lutheran; faith based org/HHS. The juveniles painted houses cleaned churches, etc...


    Michael J Klunder Timeline;
    May 15, 1971 - Michael Klunder born.
    November 1986 - Klunder's first known victim - ELG, age 15 years - Klunder's age 15 years. Klunder is sent to the Boys State Training School in Eldora, to
    Meyer Hall in Des Moines, to Bremwood (a juvenile home) in Waverly and to the Mental Health Center in Cherokee. read more-
    http://globegazette.com/news/local/michael-klunder-timeline/article_b448708a-db89-11e2-bf27-0019bb2963f4.html

    Wolfscratch

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  10. Wolfscratch,

    I was in Cherokee in 1969, two years before Klunder was born, and I left Iowa the same year. But it sounds like he's exactly where he belongs: six feet under.

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  11. Thanx for your reply, Jennifer...
    Wolfscratch

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  12. I've been in the child/adolescent ward of the MHI 4 times over the last 3 years, and I can say while it has come a long way from its founding, it is in no means a great place. It feels more of a prison than a hospital. You have to ask permission to do anything: use the restroom, sit in the main area, you even have to ask to clear your meal tray! There is one 30-minute session of group "therapy" five days a week. The rest of your treatment is solely medication. The fact they push chemicals into your body before helping you sort through the root of your illness is appalling. I, too, went in more stable than coming out. The main thing I learned in the facility is that in order to get out, you have to set aside all your dignity and agree with everything they tell you, even though that means pretending you feel better. I hope anyone else going into this hospital gets the proper care they need and deserve elsewhere.

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  13. I'm so sorry for your plight. I hope that you have an advocate who will fight for you; pumping medications into a teen seems archaic and scary.

    You write very well; just keep writing about your experiences in Cherokee.

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  14. I was a nursing student and was at Cherokee in 2002. This facility was very scary and overwhelming. The large building, towering peaks, and tile floors, and bars was more of a movie set than an institution. I can only imaging being a patient. I was appreciative of the education that I received, but very happy to be able to leave. The museum was impressive. I would have liked to have seen it in the early years when it was total self sufficient.

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  15. Thank you for stopping by.

    Yes, Cherokee is both scary and impressive in its own way.

    It was no coincidence that I used the spire for by book cover graphic.

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