Friday, June 28, 2013

Dr. Frederick L. Goddard, Dr. Henry Waldo Coe and Two Very Different Insane Asylums

by Kate Corbett Pollack

The history of mental illness has been a long and troubled one in the United States, with reform coming slowly. There are those that tirelessly dedicate their lives to change, many of whom have been lost to history and are little known. Their efforts to enact reform in mental health care often stem from personal experiences with mental illness, which has resulted in a passion and understanding others may not possess. This passion is the fuel that these reformers often use to the end of their lives, working up to their dying day to help others.
Previous APHGA blog posts have mentioned Mary Williams Howes (1823-1910), daughter of Lydia Spaulding and Ezra Howes, granddaughter of Mary Williams and Reverend Josiah Spaulding of Buckland, Massachusetts. In 1865 she married Peter Goddard, also of Buckland. She went by Mrs. P.M. Goddard or Mrs. M. W. Goddard from then on. Mary was born the year Reverend Spaulding and Mary Williams both died. Her uncle Josiah Spaulding, who was insane and kept in a cage, had been transferred from the home of Reverend Spaulding to Lydia’s house just prior to Mary’s birth. Previous blog posts about the Spaulding family say that family letters did not mention him after about 1812, when he was put in the cage. This is not the case. After receiving more letters, the APHGA has learned that Josiah was indeed mentioned.

Deborah Pomeroy Trowbridge wrote to her sister-in-law, Mary Spaulding of Southampton, Massachusetts, on November 29th, 1823, the day before Mary Howes was born. She wanted to let Mary Spaulding know how her brother, with whom she had been very close, was faring after being moved to Lydia’s house (punctuation added):

Your Dear Brother is in his new room, he was put into it Saturday Last. I think he will be comfortable this winter. Mrs. Townsley[i] says it is a warm room. Deborah has been washing his clothes today, she says you need not be troubled about Josiah for he will be took as good care of as if his Mother was alive. For the same ones take care of him now as they did then.

This letter indicates that Josiah’s other sisters, Deborah and Lydia, who had been caring for him, would continue to now that their mother had passed. Letters between Josiah and Mary prior to his being caged show that the two had a nice friendship. Mary was no doubt very concerned with him, and must have felt far away in Southampton, which was 30 miles from Buckland. In those days, it may as well have been several states away due to the circumstances of the time period limiting travel and communication. 

Mary Williams Howes was born the day after the above letter was written. She became a mental health reformer as an adult, working with her husband and son to open a therapeutic sanitarium on a mineral hot springs in Alaska for the mentally ill in the early 1900s. The memory of her uncle’s cage most likely inspired Mary and by extension, her family, to create a humane environment for people with mental disorders. Readers can learn more about her in March 2012’s two-part blog post The Descendants of Lydia Spaulding.

At the same time as Mary, her husband Peter and son Dr. Frederick L. Goddard were working to create the hot springs asylum, Dr. Henry Waldo Coe, President of the Sanitarium Co. in Portland, Oregon, was working on a rival contract. The state of Alaska in the late 1800s to mid 1900s had no asylum for their mentally ill. Federal funds had been allocated for the creation of an asylum, and the Goddards were in competition with Henry Waldo Coe over who would receive them. 

Henry, who lived in a mansion at 933 Northwest 25th Avenue in Portland, was successful and well-connected politically. He was president of the Oregon State Medical Society, whose meetings were sometimes attended by the Mayor of Portland. Originally from Wisconsin, the son of Dr. Samuel Buell Coe (b. 1835 in Randolph, Portage County, Ohio) and Mary Jane Cronkhite (b. 1835 in Oneonta, Otsego County, New York), Henry Waldo Coe began his education at the University of Michigan at Ann Arbor. His father, also a physician, was a surgeon in the Union Army during the Civil War. Like Dr. Frederick L. Goddard, Coe went on to graduate from the Long Island College Hospital in New York in 1880, seven years before Frederick did. After graduating, Dr. Coe moved to the Dakota Territory and worked as a physician in Mandan, also serving as that town’s Mayor. It was in the Dakota Territory that he met and began a lifelong friendship with Theodore Roosevelt. There he also met Viola Mae Boley, the daughter of Honorable Elijah Boley and Sarah Llewellyn of Indiana. Henry and Viola were married on June 24th, 1882. 

Viola Mae Coe was also a physician. A graduate of the Woman’s Hospital Medical College of Chicago, Viola began her career as a schoolteacher, and received her medical degree after giving birth to her first child, George Clifford. George was born in North Dakota in 1885. In 1890, Dr. Coe and Viola moved to Portland and began work to open Morningside Hospital, an asylum for the mentally ill. The couple had two more sons in Oregon, Wayne Walter (b. 1894) and Earle Alphonso (b. 1896). Viola was one of only five women physicians in the Portland area at the time. She became a founding member of Portland’s first Women’s Medical Society, and had her own private practice. Henry by this time was specializing in nervous disorders and mental illness, and the asylum project was an extension of this.
The asylum was founded in 1899 and built on 47 acres of formerly agricultural land in East Portland on 96th and 102nd avenues, and Stark and Main streets. Originally, it was not a large asylum building, but a system of cottages. A 1903 advertisement from the Pacific Medical Journal shows “Mt. Tabor (Dr. Coe’s) Nervous Sanitarium”. At the time, the asylum consisted of six buildings “situated in Portland’s most desirable suburb…and it is exclusively for the care of NERVOUS DISEASES”.  Also on the property was Mindease Retreat, which promised treatment for “selected cases of alcoholism, drug addiction and DISEASES OF THE MIND.” Pictures in the ad feature pastoral scenes and stick-style cottages bordered with Art Nouveau fences. 

Around this same time, Dr. Frederick L. Goddard had taken over the Western Washington Hospital for the Insane at Steilacoom. His parents had moved to Washington with him. Before his arrival in 1900, the hospital had been run by a businessman, and had developed a reputation as being a sort of Bedlam, neglectful of patients and not a pleasant place to be. Frederick’s management brought sweeping changes to the institution, including the release of many patients who had been committed for things like menstrual disorders and masturbation. Dr. Goddard was not interested in keeping the mentally ill in chains. He patented his own system of humane cloth and leather restraints and also thought highly of the use of water for treatment. Many of his reforms of the Washington Asylum centered on water, and he updated and enlarged the bathing area which he wrote in a report had been “repulsive”. He also directed water from a local spring for the asylum’s use to irrigate the grounds, on which vegetables and trees were planted. 

Previous APHGA blog posts on Mary, Peter and Dr. Frederick Goddard mention their Buckland, Massachusetts roots, but the family moved quite a bit. After meeting in Buckland, Frederick’s parents, Mary and Peter were married in Philadelphia and then moved to Brooklyn, where Peter worked as a cotton merchant. Frederick was Mary’s step-son, and was born in Buckland in 1862. His mother, Climera Mallory (1835-1864), died when he was a baby, and Mary and Peter were married soon after her death. Mary and Peter had begun courting when Mary returned to Buckland after teaching school in the antebellum South and working as a nurse under famed mental health activist Dorothea Dix for the Union Army. She had returned to Buckland because one of her last surviving family members was dying - her stepmother, Lois Warrniner, who had been caring for Mary’s caged and insane Uncle Josiah for decades in the family home. Josiah Spaulding had outlived almost every one of his family members (with the exception of Deborah Pomeroy Trowbridge, who lived to be 90), all of whom died from epidemic disease. Mary had grown up with her caged uncle in her house. He was first cared for by her mother, Lydia. After Lydia died in 1836 from tuberculosis, Mary’s father married Lois, who took over Josiah’s care. When Lois died, it was up to Mary to see that Josiah and his cage had somewhere to go. It had been many years since Josiah’s limbs had atrophied from being caged for so long. Mary was living in Philadelphia at the time and could not bring him with her. In what must have been a very painful decision, Mary saw that he was transferred to the Deerfield County Poor Farm. He would die there two years later, at age 81. He had spent 57 years of his life in the cage. Experiencing the treatment of the mentally ill this way must have left an indelible mark on Mary’s mind. There was no other place that Josiah could go in the area, and there never had been. Peter, who grew up in Buckland, also knew of Josiah (as everyone did) and was with Mary during the difficult time of Lois’ death and Josiah’s transfer to the Poor Farm. The fact that their son became a physician specializing in the treatment of the mentally ill was most likely influenced by their past with Josiah, a story Mary and Peter must have told Frederick when he was growing up.

Mary and Peter knew firsthand what could happen when there was no place for the mentally ill to go, and no available treatment for them. Like Dorothea Dix, the family understood the need to create asylums in places where there were none. Frederick left the Western Washington Hospital for the Insane in the early 1900s, moving to Alaska to speculate in Gold and work as a physician at the Treadwell Mine. He moved to Juneau with his family: wife Mary Clunas (the couple married in 1890 in Tacoma) and children Erwin Mallory (b.1891) and Dorothy (b. 1899). Mary and Peter, now elderly, went with them. After moving to Washington, Peter had become a plumber, which was fitting with his son’s water-based ideas of mental health therapy. Peter would be involved in the development of the mineral hot springs asylum, which Frederick and his partner, Dr. E.J. Brooks, bought in 1905 in Sitka, Alaska. The modest asylum started out like Dr. Coe’s Mindease retreat: it wasn’t a large hospital but the beginnings of what the family hoped would become Alaska’s first asylum for the mentally ill. Government contracts and support could help to make it large enough and equipped to accommodate more people over the years. Dr. Goddard chose the spot for its healing mineral waters, which he would incorporate into the care of his patients. The spot had been used by local Native Alaskans for its curative powers for thousands of years, and was considered a sacred spot.

Alaska’s mentally ill were being shipped by this time to Dr. Henry Waldo Coe’s Morningside Hospital, which had come to fruition in 1905 in a large building that the doctor purchased and had moved to his land at 10008 Southeast Stark Street. A mentally ill person in Alaska would be sent before a judge, declared insane, arrested, and put in chains like a criminal and sent to prison before being eventually shipped to Portland. This type of treatment of the mentally ill was exactly what Dr. Goddard was against. In the Biennial Report of the Western Washington Hospital for the Insane, Years 1896-7-8, Dr. Goddard wrote:

The law however should be changed so that the trial for the commitment of an insane person would differ from that of a criminal, and the conveying of the insane to the hospital should be placed in hands of parties educated in the management of the insane rather than those who are constantly dealing with the criminal. A great saving could be made to the state if the patients were conveyed to the hospital by qualified hospital attendants, and would be much more humane[ii].

Dr. Coe had been awarded a contract from the U.S. Department of the Interior in 1904 to care for mentally ill and developmentally disabled people from Alaska. This included many members of Alaska’s Native American tribes. Dr. Frederick Goddard and his family at this time had been petitioning the government for that same contract, which would allow patients to go to their Hot Springs Asylum. Dr. Coe’s wealth and political connections to then president Roosevelt, his old friend from the Dakota Territory, most likely did not hurt his chances in getting the contract. He even gifted the city of Portland with a statue of Theodore Roosevelt.

Dr. Coe’s Sanitarium Company reaped the benefits of this government contract, with hundreds of Alaskan patients being transferred to his facility, which also housed children. Running this facility made Dr. Coe a wealthy man. His banking and real estate interests served to increase that wealth. Maintaining his contract with the government was vital to his operation’s success. Dr. Frederick Goddard had to abandon the idea of a hot springs asylum and instead turned the site into a hotel. He continued trying to get the contract until at least 1915, bidding in his proposal to the Department of the Interior that he could save them money, needing only $27 per patient per month. It was the lowest bid for the care of Alaska’s patients. Other hospitals in Washington and Oregon had also made bids, but Dr. Coe’s Sanitarium Company and Morningside won the contract again.[iii]

Morningside Hospital had come under scrutiny in 1915 for never releasing patients, and for housing them so far away from their homes, among other complaints, some from patients. Dr. Coe refuted these charges in a letter to the government, calling them “malicious”.[iv] Viola Mae Coe also denied the accusations.[v] Other complaints were levied against the institution, which compelled Dr. Coe to put together a book entitled “The Insane of Alaska” in 1917, dedicating it to the Governor and legislators of Alaska in response to the bad reputation the hospital was getting. He offered as explanation: “Many of the insane believe that they are being unlawfully detained, discharged nurses are sometimes resentful, and there is always the local politician…seeking the establishment of an insane asylum in [his community’s] midst.” The book featured pleasing photographs of patients sitting comfortably outdoors on manicured lawns, engaged in activity, and rows of clean, nicely made up beds. Dr. Coe wrote later in the book that “As long as the insane are cared for, complaints will be made as to such care, regardless of where the patient may be treated…probably 99 out of every 100 complaints are the result of insane delusions…”[vi] A government inspection also cleared the institution of any wrongdoing. However, patients in this era often were institutionalized for no real reason, and were not allowed to leave the hospital. Their presence meant money for the institution and their free labor on the grounds and in the buildings often helped a place run at less expense. The hospital had an incentive to keep patients committed. People would often be committed for normal life stresses and kept in institutions until they died. But according to Dr. Coe, any complaint should not be entertained, as it was an “insane” person making it. Dr. Coe also stressed that Oregon was a much better climate for the mentally ill than Alaska, failing to recognize the more temperate parts of the state such as Sitka, which is closer to Washington.

After losing the contract yet again, Dr. Frederick Goddard resorted to having a private practice, as he had done in Juneau. He owned a house in Sitka, where the whole family lived. Mary Williams Howes wrote to her Alma Matter, Mount Holyoke Female Seminary in South Hadley, Massachusetts, to have books shipped to Sitka for the grandchildren, working to almost her dying day to keep the family educated. She would die in 1910. Her husband Peter passed in 1912. Dr. Frederick would die in 1932 of a cerebral hemorrhage. Erwin Mallory, Frederick’s son, went on to be mayor of Sitka. 

Morningside Asylum continued to transfer patients from Alaska, admitting almost 5,000 up to the hospital’s close in 1968. Dr. Henry Waldo Coe’s son, Wayne, took over the institution after his father’s death in 1927. Dr. Coe was a well-loved man around Portland and his memorial in an Oregon paper said of him, “His was a life lived in the fullest-beautiful in all its acts; carrying in his heart, as a guiding star, the thought of making the world better for having lived in it. He was thoughtful, considerate and courageous; kind towards all fellowmen, the widow and the orphan, the great and the small…courageous to the last.”[vii]

During the 1940s an inspection of Morningside found that most of its patients had no official diagnosis and were receiving little to no psychiatric treatment. In 1956 the U.S. General Accounting Office investigated the hospital and discovered that it was taking in excessive profits from inflating expenses. The Daily Alaska Dispatch on April 4th, 1950 published an article decrying the horrific conditions the mentally ill were being kept in while waiting in Alaska’s prisons for transport to Morningside:

Anchorage's Federal jail was criticized as a "fabulous obscenity" by an Interior department investigation committee report in commenting on the conditions under which insane persons must be held while awaiting transportation to the State…Dr. Fred Goddard, late owner of Goddard Hot Springs and an experienced psychiatrist, seeing the need for a mental hospital in Alaska established such an institution at the springs a number of years ago. He believed the therapeutic value of the waters was such that a great number of the mentally disturbed could be relieved. His venture was unsuccessful because of the archaic laws dealing with the insane in the territory.[viii]

Sadly, the conditions Dr. Goddard spent his adult life fighting to eliminate were still the case twenty years after his death. These conditions were also the ones Dorothea Dix saw in the 1840s when she visited a prison where mentally ill people were kept. Over 100 years later, not much had changed. The conditions were indeed archaic. The investigation into the Federal Jail in Alaska thankfully led to legislation being changed. The Alaskan Mental Health Enabling Act was passed in 1956, which ended the transferal of patients to Portland. Alaska developed its own mental health system in the 1960s.
The insane asylum as a repository for federal money was a new era in American asylums, and not a more humane one by any means. Dr. Coe’s hospital was not designed to treat patients as much as it was to house them. Psychotropic drugs replaced locked wards into the 1940s, keeping patients in a heavy stupor. If Dr. Goddard’s reforms at Steilcoom were any indication, he was not interested in profit, but in treatment and care, going so far as to design an asylum that was revolutionary for its day. 

Today, over 500,000 mentally ill people are housed in America’s prisons, which PBS recently called “The New Asylums”. No effective system was designed to replace the asylums as they began closing their doors in the 1960s-1980s. Dr. Goddard’s model of a humane, beautiful and calming hot springs asylum could have offered better treatment, and can be looked at as a model of what treatment could be like. Instead of locked wards and solitary confinement, where many mentally ill people continue to find themselves over 170 years after Dorothea Dix first brought the problem of the mentally ill being imprisoned to light, a treatment-focused program that is respectful of the patient and does not treat them as an inmate could be beneficial. 

Today, there are many families who do not know what happened to a relative in their family tree. When a person was transferred to an insane asylum during this era, they were often never heard from again, and buried in an unmarked grave. There is currently a project to find patients who were transferred to Morningside hospital from Alaska. In looking over archival documents from Morningside, many of the names on the lists are those of Native Alaskans. In the early 19th century, many Native Americans were removed from their homes and sent to Indian Schools or other institutions where attempts were made to assimilate them into white culture. Morningside was one of these institutions. It is difficult to say how Dr. Goddard would have handled this had his therapeutic Hot Springs been a success, but at least people wouldn’t have been completely transferred out of their state. Portland was a great distance from many parts of the Alaskan Territory.

[i]Family friend and neighbor Submit Townsly, who features prominently in the Spaulding letters.
[ii]Biennial Report of the Western Washington Hospital for the Insane, Years 1896-7-8, Located at Fort Steilacoom. 49.
[iii] Insane Care from Alaska is Described article, Daily Alaska Dispatch, Juneau, Juneau County, Alaska, 8 Jun 1916, p. 2/col. 2 & 3
[iv]Coe, Henry Waldo, M.D. "A Detailed Report of the Patients Who Have Been or Are Now under Our Charge as Insane from the District of Alaska." Letter to To the Honorable Secretary of the Interior, Washington, D.C. 26 June 1916. MS. The Sanitarium Company, Portland, Oregon.
[v]Viola at this time was heavily involved in the women’s suffrage movement in Oregon and in 1912 had become chair of the Oregon State Equal Suffrage Association. That year Oregon women won the right to vote.
[vi]Coe, Henry Waldo, M.D., comp. The Insane of Alaska: Cared for by the Sanitarium Company at Portland, Oregon, under Supervision of the Department of the Interior. Portland, OR: Boyer Printing, 1917. Print. 26.
[vii]"Henry Waldo Coe, M.D." Multnomah County OR Archives Biographies.USGenWeb Archives, 25 May 2007. Web. 17 Dec. 2012. .
[viii]Anchorage's Federal jail was criticized as a "fabulous obscenity" article, Daily Sitka Sentinel, Sitka, Sitka County, Alaska, 4 Apr 1950, p. 2/col. 1 & 2

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