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"I'll bet there's heat in our staff cottages, isn't there?"

"Oh, sure. Mrs. Stanhope is susceptible to colds."

"Then there's really nothing we can do?"

"I'm afraid not, Lord. Stanhope can turn down my orders for medicines, therapeutic equipment, bandages, or anything else. If his budget reads 'no,' then I can't do a thing."

"Well, sorry to have bothered you. Good night."

Dr. Lord replaced the receiver. "What a system!" he muttered. Then he addressed the attendant. "Let's take all the clothes we can scrape togther -sic- and put them on the oldest bed patients. I don't know what we'll do on the women's side -- they've been short of clothes for months. Politics and puppets! What a system!"

(Based on reports 776 and 255)

(5)

"Where there is much pretension, much has been borrowed."

-- JOHN C. LAVATER

Ward 20 was in an uproar when Bruce came on duty after his morning off. Never had he seen such activity. A crew of worker patients was waxing the floor, using two big cans of paste wax -- the kind Bruce had been ordering regularly for two months without results. The smell of pine disinfectant came from the shower room . . . the exterminators were busy in the dormitory . . . patients who hadn't worn a stitch of clothing for weeks were parading around in new brown coveralls . . . beds which had been without sheets for months were being made up with two sheets, a pillow case, a blanket, and a bedspread (Bruce had never seen a bedspread on Ward 20 in the last four months) . . . the carpenter was replacing window-lights that had been kicked out six weeks ago. And to cap the climax, Miss Vollmer came sailing around the corner at the head of a cavalcade of potted flowers and plants, and framed pictures.

Heavenly days! The place is being made over, thought Bruce, as he watched Miss Vollmer direct the placing of the plants and the hanging of the pictures. She looked a little harried, but triumphant, as she turned her attention to Bruce. "Get on a fresh white coat," she ordered, "and please keep these patients in line until after the visit. The state inspectors will be here at two o'clock sharp, and we want everything to be ready. I'll send the workers back after the plants, the pictures, the bedspreads, and the other extra things at four o'clock. You can help them store these things away again."

"Yes, ma'am." So this was the cause of all the fuss, Bruce thought. Wax he could have made last for weeks, sheets enough for two weeks at the normal rate, clothes he had been pleading for for -sic- months, and more workers than he had been able to get in a year of asking -- all expended in one great rush. And why? So that the very people who alone could improve conditions wouldn't see things as they really were. Bruce rubbed a smudge off the floor and quoted:

"Who knows what hidden sorrows lurk
Behind yon cloistered walls?"

(Based on report 279)

An amazed glance passed between Nurse White and Attendant Livingston, as Dr. Phelps continued to walk around the ward and ask questions about the treatment and the patients.

They were amazed, not that the doctor was asking questions, but that he should be on the ward at all. For five months, Mrs. White and Mr. Livingston had been in sole charge of the insulin shock ward. During that time, they had been visited just once before by a staff physician. (The superintendent of the hospital had come to the ward to ask Livingston to play a violin solo before the local Rotary Club.)

The look of amazement changed to one of amused understanding when the hospital superintendent cruised into the ward with three state officials in tow. "Now this is our insulin shock ward," the superintendent explained, bobbing his head buoyantly to Dr. Phelps, Mrs. White and Mr. Livingston. "We accomplish some miracles of medicine in this room -- cure some very difficult cases," he continued. "We treat only ten patients at a time, but everyone who needs it gets this treatment."

The three officials and their escort went out into the hall, but the superintendent's voice could be overheard on the ward: "We always have a doctor in charge of insulin shock treatment."

Mrs. White smiled at Dr. Phelps. "Do you put on a false mustache and dark glasses now, and go cover another ward?" she asked.

Dr. Phelps left silently by another door.

(Based on report 803)

CHAPTER IV
Some Things Just Aren't Done

"There are seven factors necessary to adequate psychiatric care: (1) prompt treatment, (2) decent surroundings, (3) good food, (4) good medical and surgical care, (5) good psychiatry, (6) adequate facilities for occupation and recreation, and (7) integration of the hospital with the community."

-- GEORGE S. STEVENSON, M.D.,
Medical Director,
National Committee for Mental Hygiene.

(1)

"Careless medical practice should never be tolerated by the mental hospital administration . . . Failure to investigate the somatic side of the problem is careless psychiatric practice." (3)

-- WILLIAM A. BRYAN, M.D.,

"Aren't you going to remove the gallbladder?" asked the young doctor assisting at the operation.