Epilogue for Toni
Having spent three years in the Marines, I am familiar with life under the government. You are your service number and blood type. Your rank is your identity in the group. You transfer on a moment’s notice. Your life is expendable, and the mission comes first. The individual is second in importance to the unit. I could accept this in the military as a matter of necessity but in the treatment and care of the developmentally disabled and mentally ill it made no sense to me.
I often tried to imagine what my sister’s life had been like while in the care of the State. Since she had no say in what happened to her, she was a subject of the state. The policies that directed the management of my sister showed little interest in her welfare but instead focused on the desire of society who viewed her as a threat to the public’s image of itself.
State policies were designed to manage the intellectually disabled by excluding them from society to protect it and the gene pool from the contamination of the mentally ill. To accomplish this, a trail of abuse, neglect, isolation, regimentation and horror surfaced within those massive, antiseptic hospital complexes over most of the 20th century.
For most of us not directly involved with the retarded or the institutions that house them, we catch glimpses of what life inside is like for the helpless through literature and film. Since the lives of the mentally ill are purposely so far removed from our sight and daily lives we only know about them through the eyes of the camera or pen.
Ken Kesey worked during the 1960’s at a state mental hospital. His novel and subsequently the movie “One flew over the Cuckoos nest” gives a humorous and poignant portrayal of a patient who bucks the system. He is anti-social, and his lifestyle of drinking, drugs, gambling, stealing, sex and underage girls is his form of mental illness.
In reality, he is a social deviant and not mentally ill. He fails to adjust to society for the same reason he can’t cooperate with the hospital. He is selfish, has no regard for authority and rules, lives impulsively and is only interested in pursuing his selfish interests.
Only by degree is he different than most human beings. But by placing him into the regimentation of the psychiatric ward, he becomes a rebel, an agitator, and a hero. His inability to conform penetrates below the antiseptic surface of the institution to expose the abuses of a system that to all observers seems to be a clean well-run hospital treating mental illness. The confinement of this man in a locked ward for the mentally ill seems inappropriate until his non-compliance requires that they remove a portion of his brain to make him compliant with the system.
We laugh at the antics of Randall P. McMurphy resisting the power of the institution and rebelling against the system and the authority of the state, represented by Nurse Ratchet. She is the authority figure whose impatience is exhausted with his obstinacy and noncompliance to the rules. The conflict climaxes however when she finally persuades the hospital that McMurphy needs severe medical treatment to get him under control.
During the movie, we pay little attention to the background of these scenes where patients, who could not escape the knife that cut out the frontal lobe of their brain to pacify them are now wandering around the ward. They are lost forever. Others lie in their bed at the bottom of the narcotic abyss of medications to live out the remainder of their lives on the ward. A lifetime terribly shortened due to their isolation and loss of connection to the world around them.
The electric shock sessions add bravery to McMurphy’s character as he fearlessly marches in to get his daily jolt of electricity into his brain. The insane antics that make the movie so memorable become quickly squelched by the final image of McMurphy lying in bed after his lobotomy. His head scarred by the incision for his disobedience of the rules. The long deep cut into his forehead is evidence of the removal of Randall P. McMurphy from society. The last scene the story ends the horror with the run to freedom by the Indian.
These are the institutions that people with Down Syndrome and mental illness found themselves in over most of the 20th century. How did the moral compass of this country end up pointing to inhumane treatment rather than humane in treating the weak and helpless? Where did these ideas of medicine come from and what is the underlying rationalization that justifies it?
When the Progressive Modern era arrived in the first half of the 20th century, enlightenment gained from education in science, psychology, and medicine puzzled society over how to create a better society for those without intellectual disabilities. The collective decision would not be by raising everyone up but by eliminating those at the bottom. Along with many other enlightened countries, the U.S experienced a rise in the philosophy of Eugenics. Margaret Sanger founder of “Planned” Parenthood comes immediately to mind.
“While I believe in the sterilization of the feeble-minded, the insane and syphilitic, I have not been able to discover that these measures are more than superficial deterrents when applied to the constantly growing stream of the unfit. They are excellent means of meeting a certain phase of the situation, but I believe in regard to these, as in regard to other eugenic means, that they do not go to the bottom of the matter.” (“Birth Control and Racial Betterment,” Feb. 1919, The Birth Control Review).
California was one of the leaders in implementing the means to reduce and eliminate the mentally retarded.
“In 1909, California became the third state to adopt such laws. Ultimately, eugenics practitioners coercively sterilized some 60,000 Americans, barred the marriage of thousands, forcibly segregated thousands in "colonies," and persecuted untold numbers in ways we are just learning. Before World War II, nearly half of coercive sterilizations were done in California, and even after the war, the state accounted for a third of all such surgeries.” - See more at: http://historynewsnetwork.org/article/1796#sthash.IcRkvF41.dpuf
The creation of huge hospitals and laws to contain the intellectually disabled allowed states to perform surgeries like sterilization to prevent the birth of more defective people and protect society.
Unlike the Gothic horror stories of prior centuries, where people were chained in attic’s or dungeon-like environments, these new remedies and treatments created an image of care that was more sterile and antiseptic.
To further justify the type of treatments necessary to stop the impurification of the gene pool it became necessary to find ways to remove the constitutional rights of the mentally retarded or "feeble minded individuals. The removal of protection contained in the 14th Amendment on Due Process came directly from the pinnacle of justice in the U.S called the Supreme Court. In the Buck v Bell 1927 case, the head of the “Virginia State Colony for Epileptics and Feebleminded”, filed a petition to his Board of Directors to sterilize Carrie Buck, an 18-year-old patient at his institution who he claimed had a mental age of 9.
She, her mother and daughter were considered “feeble minded” and the state moved to have her sterilized without her permission or Due Process.
In writing for the majority supporting the request to sterilize her, Supreme, Court Justice Oliver Wendell Holmes wrote the majority opinion which gave the states the right to perform compulsory surgeries without consent.
He said, “Three generations of imbeciles is enough.”
With this calloused remark, the Supreme Court empowered the states to practice compulsory medical procedures to eradicate the mentally defective from our society.
In the case of Buck v. Bell, 274 U.S. 200 (1927), the majority opinion, of the United States Supreme Court, written by Justice Oliver Wendell Holmes, Jr. ruled that a state statute, permitting compulsory sterilization of the unfit, including the intellectually disabled, "for the protection and health of the state" did not violate the Due Process Clause of the Fourteenth Amendment to the United States Constitution. The decision was largely seen as an endorsement of negative eugenics—the attempt to improve the human race by eliminating "defectives" from the gene pool. The Supreme Court has never expressly overturned Buck v. Bell.
Funding for the eugenics movement in the U.S came from foundations like Kellogg, Harriman, Rockefeller and Carnegie. It is hard to imagine all these public and private forces marshaling to defeat a small and helpless group of people who were now no longer considered citizens let alone a human being. Ironically, in the 1940’s it was demonstrated that Down Syndrome was not transmitted genetically. It simply was one birth in every 100,000.
These legal actions of lawmakers who pursued legislation to eliminate the intellectually disabled interested other leaders in the world who saw the U.S laws as a model to get rid of people who were considered expendable and undesired.
Adolph Hitler wrote in Mein Kamph how he was interested in following the legal formations in America to pursue the idea of a purified society. He initiated his remedy by ordering the murder of 200,000 people with Down’s Syndrome. He enlisted German physicians to sign off patients as "incurably sick” and then euthanize them. (German: Gnadentod).[5] "Nazi Germany was not the first or only country to sterilize people considered "abnormal." Before Hitler, the United States led the world in forced sterilizations. Between 1907 and 1939, more than 30,000 people in twenty-nine states were sterilized, many of them unknowingly or against their will, while incarcerated in prisons or institutions for the mentally ill. Nearly half the operations were carried out in California. Advocates of sterilization policies in both Germany and the United States were influenced by eugenics. This sociobiological theory took Charles Darwin's principle of natural selection and applied it to society. Eugenicists believed the human race could be improved by controlled breeding."
https://www.jewishvirtuallibrary.org/jsource/Holocaust/disabled.html
Unlike the barbarism of the Nazis, the U.S continued to focus on removing from sight and society those whose minimal mental abilities put the purity of the gene pool at risk and take steps to prevent them from reproducing. Isolation and sterilization would create a quiet attrition to eliminate this population of under desirables
I often asked myself how it was possible in a free and democratic society that the weakest of our citizens are treated so shamelessly and with such calloused disregard? Why wasn’t our government a source of refuge and rescue? Bitterly, I learned that The “State” is the machine whose purpose it is to manage a society along political and social paths to achieve what it believes is the ideal state for the majority. It successfully operates not by cooperation but coercion. The “Plan” comes first.
Anyone who has experienced the draft, penal institutions, hospitals, the military and courts know first hand what real institutional indifference and power look like to an individual.
The State has no conscience nor does it have a soul. It operates according to the mandate of law and regulation and cogs like the McMurhpys, or Toni’s of the world are consumed and discarded by it. The irony is, it is run by people whose own families and friends know first hand how difficult mental illness can be and yet put forth in campaigns the false idea that they care. But when you look at the cutbacks in funding to support the disabled you realize it isn’t true. Year in and year out funding is cut to provide for what the legislature believes are more important matters to the state or in other words to the voters.
All we hear about today is how gun buyers should be screened for mental illness yet no one offers any money.
To reduce funding for the care of the mentally diminished to pay for programs like a high-speed train is truly the Faustian bargain. To eat and drink in the halls of power, one has to put these considerations aside to pursue what is considered the greater good.
Unlike the Marines where the officers have to eat the same food as their men, we now have an upper class that is removed from the people they serve. They do not have to eat or use the same health care system suffer the consequences of their indifference. The elevation of their perspective gives them the illusion of knowing what is best for the society they are empowered to rule.
From the DMV to IRS to the head of agency unless you have power you are quickly relegated to sit in the hallway until someone is willing to see you. You become a character in a Kafka novel.
Remembering that the Supreme Court has never overturned Buck v. Bell, one needs to wonder and fear the consequences of a State defining who is provided for and who isn’t.
Like Nazi Germany, the needle just kept moving until almost anyone could find themselves characterized as undesirable and unnecessary. The questions are whether or not the State should have the power to determine who is acceptable in our society?
How much protection should do they deserve?
The most important question is: should the State have the power to kill its own citizens? I argue no. It is for the reasons stated above that I oppose the death penalty. I fear that that needle may move far enough over and include me.
The need to have “perfect healthy children” is the dream for every parent but it is delusional to believe that any human life can be perfect on any basis. It is one thing for parents to make these decisions about their baby but it is another for the government to create policies designed to determine who is of value and who is not. The basis for the eugenics legislation was the idea that minimum criteria of mental health and intelligence needed to be met to warrant protection under the constitution and be considered a person worthy of life. How fickle. Experience shows that healthy babies don’t always turn out to be healthy adults.
This philosophy was the back ground of the era when my sister entered the state hospital system, and the big doors closed behind her in 1953.
Since 1969, California passed the Lanterman Act. It was an enormous step in eliminating the hospital structure and moving Down's Syndrome people into the communities. With this law, they created an advocacy system, gave patients the right to decline health care and required hospitals to perform procedures and practices to extend the lives of Down's syndrome people. They now became invested with the same rights as all citizens. The right to pursue Life, Liberty and the Pursuit of Happiness.
Today we see the mentally retarded on TV in the special Olympics. They are being elected homecoming queens and attend public schools. Today there is no aversion to seeing them in our neighborhood. The simple reason is they are visible. They contact, connect and communicate with the members of the society where they live. The end of the depersonalization of these human beings hopefully has ended. Someday it is my hope that Buck vs. Bell will be overturned and taken off of our law books.
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