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A Mind That Found Itself: An Autobiography

Creator: Clifford Whittingham Beers (author)
Date: 1910
Publisher: Longmans, Green, and Co., New York
Source: Available at selected libraries

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Still another effective means of eliminating brutality by the introduction of refining influences would consist in the wider employment of women nurses in men's wards. To the uninitiated this suggestion will no doubt seem ill-advised; yet, at this moment, there are in this country -- and abroad, as well, -- some hospitals for the insane where women nurses, assisted, of course, by orderlies, as are nurses in general hospitals, are managing men's wards with gratifying success. (16) What is needed is a general adoption of this humane practice. Not all classes of male patients can safely or advantageously be placed in charge of women nurses; but other classes -- the more intelligent and less disturbed -- comprising thousands, can, if anything, be managed better by women of capacity than by men of any sort. The superior tact and quicker sympathy of women -- God-given qualities -- work wonders among insane men quite as readily as in the sane world. It cannot be denied that under the present regime women nurses in charge of troublesome women patients have not been entirely free from charges of cruelty; indeed, the contrary has been proved, as the results of investigations show -- but they are far less subject to this charge than men attendants. According to those superintendents who have successfully placed women nurses in charge of men's wards, thousands of male patients who now suffer at the hands of unfeeling and incompetent male attendants could be brought under remedial and uplifting influences simply by having women placed over them in positions of authority. And the salutary influence of women in wards where they are available would have a tendency, as experience has demonstrated, to spread throughout all other wards where their immediate presence is impracticable or unsafe. It would therefore seem desirable to substitute female for male nurses wherever possible.

(16) See article on this subject by Dr. Charles P. Bancroft, in American Journal of Insanity, Vol. LXIII, No. 2, October, 1906.


Such a course, too, would further simplify the problem of securing an adequate number of attendants. The services of women are easier to secure, and women readily take up nursing as a profession -- as a life-work; whereas men naturally look upon such work simply as a means of providing a livelihood until they can secure work more to their liking.


There are in this country about twenty thousand men and women working as attendants in our asylums and hospitals for the insane. Of this number several thousand arc, without doubt, individuals of refinement. Now, if a few thousand persons of refinement can work under such conditions as obtain so generally to-day in our hospitals and asylums, is it not reasonable to suppose that improved conditions would eventually attract a full complement of workers of the same type? Strange as it may seem, many attendants now so employed, enjoy their work and would not of their own choice relinquish it. And I make bold to appeal to those grinding thousands now eking out a livelihood in work apparently more attractive, but, in truth, less endurable, to seek improved conditions and increased usefulness in those hospitals where the application of the Golden Rule to insanity is now possible. In such places a feeling of security and interest soon overcomes the instinctive timidity or repugnance felt by many when, in the capacity of attendants, they first come in contact with the insane. Such contact, barring exceptional cases influenced by a too impressionable temperament on the part of the nurse, renders one, as it were, immune. It would surprise (perhaps annoy) many sane persons, were they to realize how slightly many of the inmates of asylums differ from their more fortunate brothers at large. Yet among those who have been brought into close contact with the insane this is a trite observation; and it is the key to the problem which causes so many to wonder how and why it is that men and women, at liberty to choose their vocations, deliberately cast their lot with that portion of humanity which the average person seems so willing to shun.




BUT the problem of attendants is not the only pressing one. Any alienist will agree, that the cure of the insane depends upon their care, and that to this end a proper classification is necessary. This can be accomplished only when the curable cases can be given individual attention. The manifestations of insanity vary with the original temperaments of those afflicted. Collective treatment is now the rule; but not until individual treatment prevails will the ratio of recoveries begin to move toward that inspiring figure which due progress in the care of the insane must eventually show. For the moment each patient receives the care which is his rightful portion, all abuses complained of will be doomed. Such care will kill cruelty at its source.


In the general hospital there are wards set apart for the treatment of certain diseases. Does any one believe that twenty patients, ill with typhoid fever, should, for an indefinite period, be given the same kind of medicine and the same kind of food at the same hour each day? Such treatment would result in the death of many who, with individual treatment, would recover. Yet, in a single ward in a hospital for the insane, twenty, thirty, forty, sometimes sixty, sometimes more than sixty patients, each in a different state of physical and mental health, are forced to submit to a uniform mode of living which, in a majority of cases, is not at all conducive to their well-being. In many instances this machine-like existence has been the death of patients who might have been restored to health had they been given exercise and diversion, and food of a quality and variety calculated to tempt their jaded appetites. (17) It is trite to observe that mental health depends largely upon bodily health. Since this is so, hospital managements might think less of administering drugs, and what amounts to punishment, and more about providing a suitable diet, exercise, and proper application of what mind remains, for those whose condition so clearly demands these requisites of intelligent treatment. The total cost would be less. Instead of feeding and caring for, year in and year out, the once curable cases become chronic, the State might better spend more money for a shorter period, restore the sick to health, and convert a burden into a joy.

(17) As chances of recovery never cease to exist, and as statistics show that twenty out of each hundred who recover, do so after one or more years of confinement, the standard of care for even the so-called chronic cases can never be lowered without robbing some patients of their rightful chance of rescue. Apparently hopeless cases which recover after ten, fifteen, or twenty years of absolute insanity are by no means rare, as can be proved by a study of hospital records.

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