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THE ATTIC AT WILLARD STATEHospital in the village of Willardin upstate New York was lit by abeam of sunlight streaming be-tween rows of wooden racksfilled with suitcases—men’s on theleft side, women’s on the right—alphabetized, labeled, and cov-ered by thick dust and bird drop-pings. They had been untouchedfor many years. It was 1995, andthe hospital was closing. The be-longings, once owned by nearly300 patients from the late 19ththrough the mid-20th centuries,were salvaged, shedding somelight on the stories they broughtto the hospital—stories doomedto be forgotten if not for thisserendipitous find.

We went through the assortedsuitcases, crates, and steamertrunks, sorting the fragments oflives left behind when their own-ers disappeared—usually for

decades and often untiltheir deaths—behind asy-lum walls. After choosinga small group of individu-als for closer study, weleafed through medicalcharts; searched shipmanifests; read letters,books, and diaries; un-wrapped housewares;looked at hundreds of oldphotographs; and visitedpatients’ former homes,striving to learn who

these people were before theywere institutionalized and whathappened to them afterward.

We found evidence of aspira-tions and accomplishments;virtually all suitcase ownershad worked—as nurses, nuns,

electricians, photographers, teach-ers, farmers. However, as patients,they experienced overwhelmingloss, years of isolation, and “treat-ment” that not only failed to helpbut also often turned formerlyproductive people into chronicmental patients. The followingpersonal histories of these se-lected patients are real, but thelast names are pseudonyms be-cause of legal restrictions.

MADELINE CARTIER

Madeline Cartier was born inParis in 1896. A beauty and anintellectual, she graduated fromthe Sorbonne and traveledthrough Europe and the UnitedStates after World War I, settlingin New York City in 1920. Shetaught French literature at pri-vate schools and had an activesocial life. An independent,

Lost Luggage, Recovered Lives| Peter Stastny, MD, and Darby Penney, MLS

eccentric woman, she was drawnto the occult. Over the years,she was troubled by “psychicassociations”—the often unwel-come feeling that she could com-municate telepathically with oth-ers. During the Great Depression,Madeline became destitute. Shewas committed to Bellevue Hos-pital and quickly sent on to thestate hospital system. She consid-ered her detention a serious in-justice and demanded her re-lease at every opportunity. Shewas given large dosages of psy-chiatric drugs and developedtardive dyskinesia, irreversibleneurological damage that wasmistaken for psychiatric symp-toms. Staff vainly used behaviormodification to “treat” her “fidg-ety movements, rigid stances,and facial grimaces,” which wereactually caused by the drugs.Madeline died in a board and

Madeline Cartier (above).Source. Courtesy of New York StateMuseum.

Madeline Cartier’s books and sheetmusic (below).Source. Lisa Rinzler.

The attic at Willard State Hospital in upstate New York.Source. Lisa Rinzler.

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care home in 1986 at age 90;her burial place is unknown.

LAWRENCE MAREK

Born into extreme poverty in1878 in Galicia, a remote cornerof the Austro-Hungarian Empire,Lawrence Marek was first hospi-talized in Germany at age 24years in an exuberant state. Hehad sustained a head injury froma stone throw and was noted tobe drinking excessively beforethis boisterous episode. He recov-ered and was released in lessthan a year.

He immigrated to New York in1907 and worked as a windowwasher at Bellevue Hospital,when, in 1916, Lawrence againbecame excited, “singing, shout-ing, hearing the voice of Godand seeing visions of angels”

(as stated in his med-ical record). After ashort stay at Bellevue,he entered the statehospital system andarrived at Willard in1918. After severalyears of despondency,he found a sense ofpurpose within thatrestricted world:Lawrence became thehospital’s unpaidgravedigger, a job that

developed into a major part ofhis identity. Like many of his fel-low patients who were goodworkers, he was kept at Willardfor decades after he stoppedshowing signs of emotional dis-tress. Lawrence died in 1968 atage 90, working until the day ofhis death, and was buried in ananonymous grave in the ceme-tery he tended so faithfully.

SISTER MARIE URSULINE

A tattered doctor’s bag filledwith a German bible, ankle wraps,notebooks, letters, dried out tinc-ture of iodine and many votivecards was orphaned for a longtime until we finally identified itsowner. Sister Marie Ursuline (néeTheresa Lehner) was brought tothe United States in 1903 as ayoung Bavarian girl by an ambi-

tious MotherSuperior whoneeded helpestablishing a

mission in North Dakota’s frontier.When this venture failed, theMother Superior was banishedfrom their order, and her loyal fol-lowers scattered across the coun-try. Forlorn and tormented by herown uncertain status in the order,Sister Marie landed at thedoorstep of Bellevue Hospital,stripped of her habit and theessence of her life. By the time shearrived at Willard, the doctorsconsidered her real life story to bea product of madness and con-demned her to a downward spiralof confusion, regression, childish-ness, and wild delusions. Had thedoctors taken her biography seri-ously, helped her resolve her spiri-tual problems, and mended herutter isolation from family andpeers, she might have had achance to recover. Unfortunately,she found her final resting place atWillard, deprived of the last ritesdue her as a woman of the cloth.

FRANK COLES

Nowadays, a man who kicksover a garbage can in a fit of frus-tration would hardly end upspending his entire life in mentalinstitutions. Nevertheless, this iswhat happened to Frank Coles, adebonair chauffeur, amateurboxer, and US Army veteran. Hehad been struggling to survive inBrooklyn, New York, unable to se-cure a job that would cover evenhis meager rent. Angered bybeing served a meal on a broken

plate in a Brooklynrestaurant, Frankwent outside andkicked some garbagecans. The police werecalled, and instead ofarresting him, theytook him to KingsCounty Hospital forpsychiatric observa-tion. He was sent to a

Lawrence Marek (left).Source. Courtesy of New York StateArchives.

Lawrence Marek’s suitcase (right).Source. Lisa Rinzler.

Sister Marie Ursuline (née TheresaLehner; right).Source. Courtesy of New York StateArchives.

Sister Marie Ursuline’s bag (left). Source. Lisa Rinzler.

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state hospital in Long Island andlater transferred to Willard. Frankwas one of the few African Amer-ican men at Willard. Other thanreceiving a diagnosis of dementiapraecox in 1945, he was given noattention or treatment while thedoctors worked on shipping himout to a Veterans Administrationhospital. Aside from a neatlyfolded uniform, his duffle bagcontained many pictures of rela-tives, their addresses all meticu-lously recorded. The hospitalnever bothered to contact any ofthem, even though he had beenin touch with his father, sister,and sister-in-law up until his ar-rest. Like many other veterans ofthe day who ended up in Veter-ans Administration facilities, henever made it out alive.

SUMMARY

Are the lives of persons withpsychiatric disabilities better

today? Do they have a betterchance than the owners of theWillard suitcases did of being lis-tened to empathetically, offered achoice of humane and effectivetherapies, and regaining controlof their lives? The common wis-dom is that major advances havebeen made in psychiatric careover the last 60 years, largelycredited to psychotropic drugs,but the evidence paints a bleakerpicture. Many fewer people nowspend decades in state mental in-stitutions. However, poverty; newinstitutions such as prisons, nurs-ing homes, and board and carefacilities; medications of ques-tionable efficacy and disablingside effects; and the revolvinghospital door now rule the livesof millions of Americans withpsychiatric disabilities. These sto-ries from Willard State Hospitalare still relevant because thou-sands enter our nation’s mentalhealth system every day with

limited chances of emerging un-scathed or even improved. Hospi-tal stays are considerably shorternow, but they are no moremarked by recovery and fullcommunity integration than theywere in the days of the largestate hospitals.

About the AuthorsPeter Stastny is a psychiatrist and docu-mentary filmmaker in New York, NY.Darby Penney, an ex–patient activist, is asenior research associate with Advocatesfor Human Potential, Albany, NY.

Requests for reprints should be sent toDarby Penney, Senior Research Associate,Advocates for Human Potential, 324Broadway, Albany, NY 12207 (e-mail:darby@capital.net).

This article was accepted February 11,2008.

doi: 10.2105/AJPH.2007.131029

ContributorsThe authors jointly initiated and con-ducted the study and wrote up thefindings.

AcknowledgmentsThis study was funded by the NewYork State Office of Mental Health, thevan Ameringen Foundation, and theNathan Cummings Foundation. Thecontributions of Craig Williams, MA,Senior Historian, New York State Mu-seum, and Lisa Rinzler, photographer,are gratefully acknowledged.

This article is based on the newbook, The Lives They Left Behind: Suit-cases From a State Hospital Attic (NewYork, NY: Bellevue Literary Press;2008). More information available at:http://www.SuitcaseExhibit.org. Ac-cessed March 17, 2008.

Human Participant ProtectionThis study was approved by the institu-tional review board of the ResearchFoundation for Mental Hygiene, Inc.

Frank Coles (above). Source. Courtesy of New York State Museum.

Frank Cole’s belongings (below). Source. Lisa Rinzler.