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Here the model sanatorium -- a place of considerable freedom -- should intervene. In time the several States (following the enlightened example of Germany) will no doubt erect such institutions, but so much remains to be done by the States in the way of improving existing State Hospitals and asylums that the immediate creation of these indispensable adjuncts to a perfect hospital system must be undertaken by public-spirited citizens, possessed of wealth and the impulse to spend it for the good of those less fortunate. If one man, Mr. D. O. Mills of New York, may erect and operate, at a fair return on his investment, hotels which provide self-respecting poor with wholesome surroundings and good food, and still charge only nominal rates for the accommodations, why may not philanthropy and business be likewise combined for the benefit of those threatened with nervous or mental collapse? This class would include those who, after treatment in a Psychopathic Hospital, must continue treatment of some kind for the few months which will elapse before they are again in condition to engage in gainful occupation. In suggesting that the "Mills Hotel Plan" be applied to the sanatorium field, I think I am on safe ground; and I trust that individuals of wealth will turn their attention to a field so rich in possibilities that it may be worked at a profit that can be measured not only in money, but in service to mankind.

Perhaps, if I give an added chapter of my experiences, those in a position to correct a great evil will be the more ready to undertake the work.

XXXIX

THE particular evil I have referred to at the end of the preceding chapter is the heartless way in which many owners of private hospitals and sanatoriums take advantage of people in distress. Knowing that the relatives of an insane person will seldom place him in a public institution until their resources are completely exhausted, these owners proceed to drive almost as sharp a bargain as they would were they trading horses with a known trickster. The desire to succor distressed relatives is an emotion scarcely known to this type of man. Commercialism, not philanthropy, is his passion. "Pay the price or place your relative in a public institution!" is the burden of his discordant song before commitment. "Pay, or get out!" is his jarring refrain when satisfied that he has exhausted the family resources.

Though I am well within my rights in criticising the quality of heart exhibited by typical owners of such institutions as are run, for personal gain, it is only fair to point out that this hardness of heart of the individual is but a chip off the stumbling-block of public apathy. So long as the public refuses or neglects to establish hospitals where the insane may receive the best of treatment at minimum cost, is it reasonable to expect individuals to invest fortunes in a responsible and irksome work unless they see the chance to extort an unfair return? Assuredly not. In fact, these owners, by much and continued thought, have tricked themselves into the belief that they are indeed public benefactors -- wherein they are not entirely wrong, for they have, in a measure, filled the gap that exists in our hospital system of to-day.

Do you imagine that I speak with undue severity? Let me then refer to certain hitherto unrecorded incidents in my own life. They occurred while I was an inmate of a private sanatorium of the type condemned. The institution in question, though by no means deserving of rank among the best, is one of the largest of its kind in this country. From a modest beginning, made not many years ago, it has enjoyed a mushroom growth, and to-day harbors about two hundred and fifty unfortunates. Its material equipment is cheap. It is composed of a dozen or more small frame buildings, suggestive of a mill settlement. Outside the limits of a city, and in a State where there is no official supervision worth mentioning, the owner of this little settlement of woe has erected a nest of veritable fire-traps. Within these the most helpless of all mankind are forced to risk lives which may, or may not, again be of real value. This is a dangerous economy, but it is of course necessary if the owner is surely to grind out an exorbitant interest on his investment.

The same spirit of economy pervades the entire institution. Its worst manifestation is in the employment of the meanest type of attendant. In a State Hospital for the Insane there is perhaps some slight excuse for limiting the remuneration of attendants, for there the appropriation for maintenance per week is limited usually to three or four dollars for each of the patients. But, in private sanatoriums, where the average minimum charge per week is, as a rule, twenty or twenty-five dollars, and where many patients pay forty or fifty dollars or more, there is no excuse for an economy so pernicious. The owner of such a gold mine cannot honestly plead that a lack of funds forces him to employ attendants who are willing to work for a paltry eighteen dollars a month -- $4.50 per week -- a wage which kitchen servants frequently refuse to accept. Occasionally a competent attendant consents to work here when there is a scarcity of profitable employment elsewhere. Witness the young man who, shortly after my arrival at this private institution, providentially (for me) sought and secured a position. He received only eighteen dollars a month at the beginning; the sixth and last month of his employment there he received the same meager wage. This man, so long as he remained in the good graces of the owner-superintendent, was admittedly one of the best attendants he had ever had. Yet aside from a five-dollar bill which a relative had sent me at Christmas and which I had refused to accept because of my belief that it, as well as my relatives, was counterfeit -- aside from that, this competent attendant and charitable friend received no additional rewards. His chief reward lay in his consciousness of the fact that he was protecting me against injustices which surely would have been visited upon me had he quitted his position and left me to the mercies of the owner and his ignorant assistants. To-day, with deep appreciation, I often contrast the treatment I received at his hands with that which I suffered during the three weeks preceding his appearance on the scene. During that period, not fewer than seven attendants contributed to my misery. Though some of them were perhaps decent enough fellows outside a sick-room, not one had more right to minister to a man in my condition than has a butcher to perform delicate operations in surgery.