Patient Observation

I had a perfectly normal childhood in Wichita Falls, a place Advertising Age once called the most average city in America. But I didn’t truly understand where I was from until I stepped inside the gates of the local state hospital and realized that every town has another side.

June 2010By Comments

An undated photograph of the Wichita Falls State Hospital, whose population peaked at 3,481 patients in 1955. Today it has fewer than 240.

One summer afternoon in the late sixties, when I was ten years old, I went swimming at a friend’s house on the very last street of a subdivision on the southern edge of Wichita Falls. When I stood on the diving board, I was able to see over the wooden fence that separated the backyard from acres of undeveloped pastureland. Maybe a mile away, silhouetted against the horizon, I could make out a cluster of dignified, red-brick buildings trimmed with limestone. Some of them were three stories high, as big as oilmen’s mansions.

I stood there, barely breathing. The next week, I visited my friend again, grabbed a pair of binoculars from his parents’ bedroom, and returned to the diving board to get a better look. My friend’s father, a prominent gynecologist in Wichita Falls, came outside, shaking his head, and asked what the hell I was doing.

“Looking for the lunatics,” I replied.

The buildings, 35 in all, made up what was then known as the Wichita Falls State Hospital. They were home to nearly two thousand Texans who suffered from paranoid schizophrenia, chronic depression, bipolar disorder, and a whole host of other mental problems that no doctor could explain at the time. Like every kid who grew up in Wichita Falls, I had heard all sorts of stories about the patients—a man who believed he could fly, another man who drank his own urine, a woman who could not stop biting her fingernails, and her roommate, who kept pulling out her own hair.

At Friday night sleepovers, my friends and I would sit in the dark, holding flashlights under our chins, scaring one another with the tale of the homicidal maniac with a hook for a hand who had escaped from his padded cell and attacked two teenagers who were parking on a secluded dirt road. (Just as he’d slammed his hook into the car door, the terrified couple had raced away, ripping off his arm.) We swapped details about the patient who had received a lobotomy and who still walked, zombielike, through town on moonlit nights, looking for children to mutilate. And no sleepover was complete without a thorough accounting of what we all knew about the nymphomaniacs who supposedly lived at the hospital, beautiful, long-haired women in their early twenties who were being treated for their sexual obsessions, caused by drinking too much Spanish fly.

Wichita Falls was a small, starkly normal city of about 100,000 people—so normal that Advertising Age would later call it America’s most average city. It had three downtown movie theaters, a public library open six days a week, and both a YMCA and a YWCA. My friends and I grew up in homes full of bronzed baby shoes, needlepoints that read “Bless This House,” and family portraits taken at Olan Mills. Our fathers came home from work and sat in their La-Z-Boys, watching Walter Cronkite, while our mothers fixed meat loaf dinners in kitchens illuminated by fluorescent lights. For us, the state hospital, which nearly everyone referred to as LSU, or Lakeside University, because it was located across from Lake Wichita, was our real-life haunted house. The fact that two thousand adults were being treated for “insanity” out in those buildings, just past the city limits sign, simply tortured our imaginations. Indeed, one of the great rites of passage for kids in Wichita Falls was to pile into the bed of a pickup at dusk and race past LSU. Someone would always pretend to see a patient lurking behind a mesquite tree with a knife in his hand, and everyone would start to scream, the girls clutching their boyfriends, as the driver slammed his foot on the accelerator and sent the truck fishtailing down the road.

But that was as close as anyone my age got to the hospital. Nor did we ever get a good look at any of the patients except on those rare occasions when we saw a few of them coming through the city in the hospital’s old yellow bus, on their way to the Wichita Mountains for a field trip (with a stop at the Holy City of the Wichitas, an area that had been made to resemble Israel during biblical times). Our hearts pounding, we’d stare at them, barely making out their faces through the smeared windows, and they’d stare at us—and suddenly the bus would be gone, exhaust billowing out of the tailpipe and hanging in the air like a ghost.

Everything changed, however, when I was a freshman in high school. A new hospital superintendent named Mark Huff had arrived, and he and his staff began inviting the sane of Wichita Falls out to the hospital to meet the insane. Apparently Huff believed that such a grand intermingling would help rehabilitate the patients and perhaps help them rejoin the outside world.

The leader of my Boy Scout troop, Mr. Hamlett, a good-natured, backslapping newspaperman who was always exhorting us to become better citizens, thought this was a fine idea. Toward the end of one of our Monday night meetings, just before we all held hands and prayed to the Great Scoutmaster of All Scouts, he announced that we would be going out to the state hospital for our monthly service project. “That’s right, boys,” he said. “We’re off to LSU!”

My fellow Scouts and I looked at one another. We could barely believe what we were hearing. Were we really going to meet the lunatics?

Mr. Hamlett gave us a huge grin. “And you better be on your best behavior. I don’t want them getting any ideas about keeping you!”

Legend has it that in the early 1900’s, the Legislature offered the city fathers of Wichita Falls either a major new university, which was to be called Texas Tech, or an insane asylum. “Our leaders, in their great wisdom, weren’t so sure about the possibilities of higher education,” said Edgar Shockley, a high school classmate of mine who is an amateur Wichita Falls historian. “But they went gangbusters over an asylum. They figured there would never be a shortage of crazy people.”

The hospital opened in October 1921, the sixth of its kind in the state. Within months, dozens of patients began arriving, some of them dropped off at the front gates by their families. More residence halls were constructed, with huge wraparound porches to help the residents stay cool in the summer. Farms were cultivated in the surrounding fields so that patients could grow crops and raise their own hogs, chickens, and cattle. A chapel with stained glass windows was built in the center of the campus, and a cemetery was added in the back for those patients who died but whose bodies were not claimed by relatives or friends.

Largely because doctors didn’t understand how to treat mental illness, the patients were subjected to a variety of peculiar procedures. In hopes of fighting brain infections, a “fever machine” was used to raise a patient’s body temperature to at least 104 degrees. Hydrotherapy, involving steam baths and wet packs, was used to calm excited patients, and electroshock treatments were widely administered to depressed patients.

Finally, with the introduction of medications such as Thorazine in the mid-fifties, many patients began to show improvement, and the hospital’s population, which reached a peak of 3,481 residents in 1955, steadily began to decrease. Yet it remained a busy place. Besides the traditionally mentally ill, alcoholics and drug addicts were also sent there, as were senile senior citizens. A building was set aside for the mentally disabled. There were still patients in the residence halls who had been brought in years before because they had developed depression during menopause or had gotten brain damage from untreated syphilis or because they were epileptics who were unable to control their “fits.” The hospital even housed a few locals who had literally driven out to the hospital, parked their cars, and checked themselves in, declaring to the woman at the admissions desk that they were consumed with despair.

In May 1971, after the superintendent was fired over allegations that he had mistreated employees, state officials offered the job to the 63-year-old Huff, a silver-haired psychiatrist who looked like Cary Grant. Huff had his own successful private practice in Wichita Falls, but as a young man, he had worked at state hospitals, and his time there had deeply affected him. “He wanted to change the usual way state hospitals treated their patients,” said his son Mark Huff Jr., a retired orthopedic surgeon. “He wanted his patients to know what it was like to live without the stigma of mental illness. He wanted them to feel dignified, not hidden away like prisoners.”

As part of his open-door policy, Huff and his staff arranged for the Kiwanis Club to hold a weekly bingo game for the patients. They persuaded ladies’ groups to bring homemade cakes to celebrate female patients’ birthdays, and they asked businessmen to come have lunch with the patients and talk about their jobs.

And then came the afternoon in the fall of my freshman year when the members of Troop 13, our uniforms neatly pressed, climbed into the Scout van, which smelled like mildewed pup tents, and headed down Kemp Boulevard. No one spoke as the houses dwindled away and the red-brick buildings came into view. Behind a simple chain-link fence, which I realized anyone could have climbed over, we saw a few patients strolling around the perfectly mowed lawns and sitting at one of the concrete picnic tables. We were especially stunned to see that they were wearing normal clothes. We assumed they would be in white prison uniforms.

As we approached the front gate, an older man stopped raking leaves and gave us a curious look. “Oh God, he’s got a rake,” murmured a Scout next to me.

“Come on now, boys,” said Mr. Hamlett.

We were greeted at the administration building by a social worker who gave us a tour of the grounds. As we walked down a sidewalk, another Scout pointed to barred windows at the top of one of the residence halls. “I bet that’s where the homicidal maniacs are kept,” he murmured, as Mr. Hamlett snorted through his hairy nostrils. We swiveled our heads back and forth, searching for the nymphomaniacs. Rumor had it that they lived near the chapel in one of the bigger residence halls. But they were nowhere to be found. “Maybe they’re in a counseling session,” I said solemnly. “Maybe they’re talking about all the sex they want to have.”

We walked past more residence halls. Behind the screened porches, a couple of men called out to us in strange voices, more like shrieks, causing us to nearly jump out of our skin. We walked past the adolescent unit, which had just opened. On one wing were sullen boys who had been deemed “incorrigible” at their schools or who had spent most of their youth running away from home. On the other wing were vacant-eyed girls, some of whom wore bracelets to cover the scars on their wrists. We peered through the windows, hoping to spot a troubled boy we knew from our neighborhood who had suddenly stopped coming to school after his parents had caught him sniffing bug spray. We had been told he was living at the hospital in a private room, staring day and night at a wall and mumbling to himself.

Finally, we reached the geriatric unit, where a group of patients, a few of them in wheelchairs, were waiting for us in the dayroom. Mr. Hamlett handed one of the Scouts a rope and had him tie knots. Someone else showed his sash covered with merit badges. One Scout put his arm around another Scout, demonstrating how to save a drowning person. We then held up the first three fingers of our right hands and recited the Scout oath.

As we reached the part about doing our duty, an elderly man went over to a corner of the room and started turning circles. Another man put his hand down his pants and made what I would later describe to my parents as “up and down motions.” An ancient woman suddenly rose from her chair, panting. She reached out her arms, grabbing at my neckerchief, apparently desperate to be held before she suffocated to death. “Save me, my son,” she gasped as I backed across the room.

“Don’t mind her,” the social worker said sweetly as a ward attendant led the woman away. “Miss Lucy is just having one of her spells.”

For reasons I couldn’t then explain, I kept returning to the hospital. I showed up with members of the high school speech team and delivered an oration to a group of patients, precisely seven and a half minutes long, about why President Richard Nixon should resign. I went back to the geriatric unit, where I was asked to read to the patients from a photo book of famous United States vacation spots. I held the book above my head so everyone could see each photo. “New York City, the greatest city in the world,” I declared, turning the page. “The Grand Canyon, in Arizona!” Once again, Miss Lucy stood up and reached out her arms, asking me to save her.

Other young people arrived to entertain the patients, including the teenage youth group from the First Baptist Church, which played volleyball against the boys and girls from the adolescent buildings. (The patients, who seemed to find great satisfaction spiking the ball into the faces of the earnest young Baptists, won two games out of three.) In September 1971, in what had to be one of the more innovative therapeutic procedures since Freud had his patients lie down on his couch, Huff had the Wichita Falls High School marching band parade down the main lane of the hospital grounds, playing the school fight song along with such peppy numbers as “Three Cheers for the Red, White and Blue.” Patients lined the avenue or stood on their screened porches, clapping along to the music. The event was such a success that other school groups were invited to perform, including the orchestra, of which I was a member. We walked to the stage of the chapel and put on our most cheerful smiles as a large number of patients were escorted in. Then we launched into a medley from The Sound of Music. Mr. Holcomb, our director, kept nervously turning around, worried about what patients might be doing behind his back. At one point, a man, hidden away in the audience, began singing along at the top of his lungs. After he was led out of the chapel, another man walked up to the stage and tried to grab the leg of one of the female violinists. Mr. Holcomb, disconcerted, waved his baton at the man in a vaguely threatening way.

Under Huff’s direction, the hospital became a town unto itself, a community of odd souls who had never been able to make it on the outside. Huff went so far as to allow many of the patients to walk unescorted around the grounds. They dropped by the hospital’s library to check out books, visited the Fashion Shop to pick out clothes, got their hair cut at either the barbershop or the beauty shop, or watched such movies as True Grit and Viva Las Vegas, which were shown in the chapel on Thursday evenings and Sunday afternoons. Men could spend their afternoons at the hospital’s woodworking shop while women headed off to the crafts room to decoupage and knit sweaters. Patients could learn to paint landscapes and self-portraits in the art studio. They could join the chapel choir and sing at Sunday services (another patient played the organ). They could also try out for the Patient Drama Club, which once presented a three-act play titled The Leader of the Pack, which was described as “a comedy based on the gangsters of the 1950’s.”

There was even a monthly newspaper, the Hospital Herald, which was largely staffed by patient correspondents. They wrote editorials about ways to improve the hospital. They submitted book reviews and poems (“Nowhere to go, nowhere to roam,” wrote one Robert F., a resident of Ward 14. “Lost alone, lost to the dark”). They chronicled the various field trips the hospital had arranged for the patients. One group went to see a rodeo, another group visited the local Y for a Wednesday night swim party, and the adolescents were taken to the Southwestern Bell plant downtown to look at the new keypad phones that were replacing the rotary ones. The correspondents covered all the hospital’s parties, including the annual Halloween bash, in which the patients wore costumes, and the Fourth of July celebration, where everyone gathered to watch fireworks and then danced to the music of the Grady Solomon Band, a local group whose leader was a hospital employee.

The newspaper also reported all the latest news from the various residence halls. Ward 3, readers learned, got a new color television. B Ward started its own charm class (“The lady who keeps herself most neatly for a week using the beauty school method gets a jar of coffee,” the writer noted). In the popular Periscope column, new patients were greeted by name, returning patients were welcomed back, and patients who were being discharged were given a fond farewell. There were brief items about some of the longtime residents—“Vernie B., veteran patient here 31 years, from Happy, 35 miles south of Amarillo, would like to go home”—and occasionally the column passed along some juicy gossip. One item hinted that a great romance had taken place at the hospital, leading to a thrilling, over-the-fence escape: “Eugene B. done flew the coop Sunday nite along with Mary D. of E Ward,” the Periscope announced. “Too bad, Louis, there goes yore woman.”

Years later, while I was giving a speech to a college class, I was asked why I went into journalism. I suddenly blurted out, “I think it all started when I went out to the state hospital.” Although this had never occurred to me before, it instantly seemed right. I realized that what I loved about my visits was that I got the chance to study people who went right up to the line of normal behavior—and then, inexplicably, stepped over it. I was captivated by the patients and tried to fathom what it felt like to be swept away by madness. One day, I saw a man sitting on a bench, drawing one picture after another of Elvis Presley. What, I wondered, had happened to him? Another day, I watched a man who puffed on a corncob pipe while carrying on a conversation with an imaginary person. Who, I asked myself, was he talking to? And then there was the day I watched a female patient who believed she was an heiress who owned the hospital. “Out of my way,” she called as she walked up and down the sidewalks, a shawl thrown dramatically over her shoulders. “Out of my way!”

One Sunday morning I went along with my father, a Presbyterian minister, to the chapel, where he had been asked to lead the morning service while the hospital’s chaplain, Chaplain Owen, was on vacation. Owen was well-known at the hospital for delivering sermons that were more like hearty self-help speeches than theological expositions (among his sermon titles: “Coping With Life’s Trivialities,” “Unglue Your Guilt Feelings,” and “You Are God’s Somebody”). My father, a traditional pastor, based his sermons on a biblical event, like Jesus’ walking across the water, and he always concluded with some remarks about what such a story should mean to us today. That morning, after he finished speaking, a man came up to him and said with absolute sincerity, “Reverend, I’ve met Jesus. He and I sat down and talked. He asked me what I liked to eat for breakfast.”

I just stared at him, almost envious, wondering if his madness had given him some sort of vision, perhaps even a clarity, that I would never possess. But on another afternoon, while I was standing in my front yard, a man pulled up in his car. In the backseat were two little boys who looked like they were about to cry. The man rolled down the window and in a halting voice asked me, “Do you know . . . ” He paused. “Do you know where the loony bin is?”

I went inside, found my father, and led him to the car. On a scrap of paper, he wrote some directions for the man, and then they talked at length in quiet voices. “His wife—the boys’ mother—has lost her mind,” my father later told me. “They don’t know what to do.” My father sighed and looked at me. “I don’t want you to ever forget what mental illness can do to a family.”

I did not have to be reminded. For all my fascination with insanity, my trips to the hospital also left me with a sadness that I had never before experienced while living my very average life in my very average city. So many of the patients I met—people who probably had childhoods similar to mine—were hopelessly confused, their minds forever broken. I saw them bend down and try to pick the blue flowers that were part of the mosaic on the floors in the residence halls. Some of them just sat on couches, their eyes moist and unblinking, their bodies occasionally jerking back and forth. Others were so catatonic that they had to be lifted into the shower and scrubbed with a brush. Edgar Shockley, who went out to the hospital with the Kiwanis to help run the bingo games, told me about meeting a woman who had come to the hospital when she was a girl. “She didn’t know how to use a telephone,” Edgar said. “I’m not sure she had ever been in a car. Her whole life was centered on eating three meals a day.”

Periodically, there were suicide attempts, patients who tried to hang themselves from doorjambs. One woman climbed over the fence, walked to a service station, doused gasoline all over her body, and set herself on fire. A few of the patients were indeed dangerous. Mandy Darner, another teenage volunteer from those years, told me how frightened she was one afternoon when she found herself cornered in a dayroom by a man who had a history of sexual assault. Luckily for her, the man was going through a phase where he believed he was a preacher. As he held up a Bible and talked about hellfire and damnation, she made a quick exit.

“But really, the moments when I felt nervous were few and far between,” Mandy said. “Almost everyone I met at the hospital was just so grateful to be there.”

In fact, for all the sadness at the hospital, many of the patients saw it as their refuge—the one place where they didn’t have to endure the ridicule or abuse that was so often visited upon them on the outside. Here, they didn’t have to feel any sense of shame. Here, they could find some sense of comfort. How could anyone complain about that?

In February I returned to Wichita Falls to visit the hospital for the first time since high school. The campus was still eerily beautiful, its buildings almost gleaming in the morning sunlight. But it felt like a ghost town. As I drove past the front gate, I didn’t see a single person. Some of the residence halls, including the one where the nymphomaniacs allegedly lived, were boarded up. The administration building, which used to be teeming with staffers and patients, was so quiet that I wasn’t certain if anyone was there.

I headed for the office of the superintendent, Jim Smith, a congenial man who had started working in state hospitals in 1975, when he was studying social work in graduate school. (He also runs the facility in Vernon, 55 miles away, where 340 of the state’s criminally insane patients are kept; the campuses in Vernon and Wichita Falls form what is now called the North Texas State Hospital.) Smith told me that on an average day, only 240 patients reside on the Wichita Falls campus. He said they are given state-of-the-art medications, they receive some “recovery-oriented behavioral therapy,” and then they are discharged. Most of the patients, he added, stay less than thirty days.

“That barely gives them time to learn the names of their aides or therapists,” I said, startled.

Smith gave me a gentle smile and told me that the hospital I once knew no longer existed. “You might not have realized it, but it actually was already starting to change when you were still coming out here,” he said. In the seventies, mental health experts throughout the country were declaring that the time had come to deinstitutionalize state hospitals. They claimed the hospitals were moribund institutions that allowed patients to remain huddled away in their solipsistic inner worlds. The most effective way to deal with the mentally ill, they said, was to keep them close to their families and have them treated at community outpatient clinics or halfway houses, thus giving them a better chance at remaining a part of society.

The reputation of state hospitals wasn’t helped by the Oscar-winning One Flew Over the Cuckoo’s Nest, which was released in November 1975, my freshman year in college. Politicians got in on the act, ordering more cutbacks, realizing they would be able to save tens of millions of dollars if they shut down most operations at state hospitals. By the late seventies, the daily census at the Wichita Falls facility had dropped to six hundred patients. Huff retired in 1981, at the age of 73, devastated over what had happened to his beloved institution. “He used to say that so many of his patients who had been pushed out of the hospital had no place to go and would end up either in jail or homeless on the streets,” his son later told me. “Today, all you have to do is drive through any downtown of any city, look at all the mentally ill loitering on the sidewalks, and you’ll appreciate what my dad was predicting.”

Smith took me outside to show me a cluster of remodeled buildings surrounding one of the lawns. It looked like a small village, complete with a pharmacy, a snack bar, a game room with billiards and Ping-Pong tables, a hair salon, a movie theater with a marquee, and a new library and clothes store.

“We call it the Village Square,” Smith said. “We raised one hundred fifty thousand dollars from private foundations in Wichita Falls to build it. We wanted our patients to practice behaviors they will have to do when they leave us, like walking into a pharmacy and picking up their medications or sitting through a movie without causing a disruption. Someday I’d love to add a real bank and a nice restaurant—maybe a grocery store. Who knows?”

I gave Smith a curious look. Despite all the cutbacks, the spirit of Dr. Huff lived on.

Before I left, Smith wanted me to see the newly remodeled geriatric building, where I had once tried to evade Miss Lucy. He introduced me to the geriatric program’s director: It was Mandy Darner, the former teenage volunteer. “This place had such a strange impact on me that I couldn’t get over it,” Mandy told me. “I ended up studying social work in college just so I could come back.” A few minutes later, at the administration building, I was stunned to run across Roddy Atkins, another former high school classmate, who had been the star of the tennis team, renowned for his wicked backhand. My friends and I figured he would play on the pro circuit. Instead, he told me, he had taken some psychology classes in college, spent a summer working at the hospital’s adolescent building, and found his calling.

“You remember how our teachers used to get really mad and tell us that they were going to have us committed to LSU if we kept misbehaving in class?” asked Roddy, who is now executive director of the Helen Farabee Regional MHMR Centers. He chuckled. “Well, here I am.”

Roddy admitted that, because of all the cutbacks in mental health services, he was worried that more mentally ill citizens are falling through the cracks, not getting help soon enough. “That’s when they get in trouble,” he said, “committing crimes, ending up in the back of a police car, and waiting in jail for a space to open up at the hospital.”

It’s likely the wait is going to get longer. The day before my visit, the news had broken that state mental health officials, required by the governor to cut their budget, had proposed reducing the number of beds at four state hospitals, which would mean the elimination of 109 jobs in Wichita Falls. Smith pressed his lips together and said, “Whatever happens, we will do all that we can for those who come to us. We will give them whatever help they need, and we will give them comfort. That is our duty—to care for the afflicted.”

I shook everyone’s hands and headed back to my car. In the distance, I looked off to where my friend once lived, where I’d stood on the diving board and gawked at the hulking brick buildings. But the neighborhoods had changed so much that it was impossible to find the spot. A group of patients was shuffling my way, escorted by a staffer holding a clipboard (hospital rules now require that all patients be escorted whenever they are outside the residence halls). A couple of them seemed slightly off balance, their heads cocked to the side. I couldn’t help myself. “Hi,” I said to one of the younger men as he passed by. For a moment, he gave me a bug-eyed look. His skin was as pale as milk. But then he started smiling, delighted that he had been noticed.

“Hi, you,” he replied.

Related Content

  • Lacie Lippard

    Wheres the rest of the story?