Stories Without Names and In Memory of Aunt Lizzie
by TYLER SCOTT
“We’re learning that we should not be ashamed of our mental illness,” I overheard as I was driving the van to the YMCA. I looked in the rearview mirror at the twenty something male wearing a Yankees cap—I’ll call him B. It was not a face I would have associated with nervous breakdowns, hospitalizations and two doses of lithium, Ativan, and one of Risperdal each day. Diagnosis: schizoaffective disorder, symptoms of both mood disorder and psychosis. Former life: wife, baby, good job at a Fortune 500 company. Current life: resident of a life skills program which teaches the mentally ill how to live independently.
When I started working at this non-profit a few years ago, I knew little about mental illness. I’d had cases of the blues, relatives and friends who’d battled depression, knew stories of people who’d cracked up—like some of my favorite writers. But if you’d pressed me, I could not have given a clear definition of nervous breakdown or schizophrenia. To define schizophrenia I would have said split personality which is inaccurate, a notion I’d learned from the movie “Sybil” starring Sally Field where she had multiple personalities. Most of my knowledge of mental illness was based on books, movies, and television—The Bell Jar, I Never Promised You a Rose Garden, One Flew Over the Cuckoo’s Nest, the poetry of Anne Sexton.
My experience didn’t change much as I grew older. Growing up, there were a few suicides in my hometown, always whispered about, and a couple of girls at my boarding school made weak attempts like the one who OD’d unsuccessfully on No Doze. During my single days, a well meaning friend set me up on a lunch date with a powerful handsome attorney a bit older than I. Shortly before the rendezvous, I found out the reason the rich and powerful attorney was now available was he’d had a nervous breakdown the previous year. I ate a quiet lunch with a dapper man in a blue checked shirt, very tanned with movie star eyes. Obviously very bright. But there was something shaky and unstable about him, I couldn’t quite put my finger on it, and I noticed small scabs on his face and arms. I didn’t go out with him again.
The non-profit I worked for is tucked away on thirty acres in a rural area just starting to develop outside of Richmond, Virginia. Millionaire McMansions are mixed among the farmhouses and small forgotten churches. Most people get lost on their first visit to the campus and the quiet gray buildings seem very peaceful in the distance. The program teaches those with schizophrenia, bipolar disorder, and depression how to live independently in the community and they can participate for six months, three years, or the rest of their lives. It’s a campus lifestyle for about 30 residents and 22 staff; twenty more live in the community with assistance. The organization is divided into three parts: the first level, the group home, where people enter at their sickest, usually from a hospital or jail, and they have 24-hour supervision where they are assessed, learn about their illnesses, medication management, and in some cases basic hygiene; the Supported Living Level where they move into their own apartment on campus, usually with a roommate, and take classes in cooking, shopping, budgeting, job interviews, computers, relationships and any other life skills needed to make it out there. The last phase of the program is Community Support where they move off campus into an apartment and either work part time or go back to school, still with the program’s support whether it’s transportation, therapy, or social events. Since the residents usually move into neighborhoods you and I would never visit, it should come as no surprise many were reluctant to move off campus.
Most of the residents were indigent. With private pay facilities costing as much as $9,000 per month, it’s no wonder family members had often exhausted their resources by the time their relative had been accepted. I took many phone calls from concerned relatives, often sounding desperate. There was always an increase of these calls around Christmastime.
Until fall of 2007, I worked as the Director of Development. Our small staff was expected to raise about $350,000 which would offset about half the cost of each resident along with fees from SSI, Disability, HUD and Medicaid.
This was all well and fine until Virginia Tech.
As we now all know, on Monday, April 16th, a young student named Cho Seung-Hui got up, dressed, walked over to the dorm next door, and shot two people to death. He went to the post office and mailed a video of his rants against the world to NBC News, returned to campus and entered a classroom building, locked the doors and walked from room to room gunning down people. Final toll: 33 murders of faculty and students, twenty-five wounded, and Cho killed himself. Within hours everyone wanted to talk about the plight of the mentally ill and the holes in the system.
It has been a cruel wake up call, especially in my home state Virginia where all of us were so closely affected by the tragedy. As a Richmonder, it was even closer to home since so many Tech students come from Central Virginia. Three of my neighbors knew victims well and my daughter’s third grade teacher said she had six families in her class who were closely affected by the killings—the worst kind of six degrees of separation. On a sad and professional note: For those of us who were fundraising for non-profits helping the mentally ill, the following months were lucrative. Corporations which had not paid attention to us for years were suddenly sending large grants.
A backward glance at the history of mental health treatment is an ugly view indeed. Burning witches at the stake...trepanning...snake pits...lobotomies...shock treatments...hospital patients so doped up they literally couldn’t remember years of their lives...patients who shouldn’t have been committed in the first place.... In 19th century England one could pay a penny to peer into the cells of lunatics and watch for entertainment. (Hey, the sex and fights were great!) Admission was free on Tuesdays and visitors were allowed to bring sticks so they could poke the mad. In 1814 alone one hospital logged 96,000 visitors. Popular as NASCAR.
This early treatment of the insane is beautifully captured in William Hogarth’s print “The Rake’s Progress,” a print of the world’s oldest psychiatric hospital Bethlehem Royal Hospital in London. (And also called Bedlam.) The print is so named because back then, it was thought insanity was linked to moral weakness. “The Rake’s Progress” is hell in grey tones: two women caressing (!); a mad fiddler wearing a down turned book as a hat; a half nude and bleeding man, crying, in chains, and having a fit; a man staring off in the distance; a woman playing with string. Over 200 years later I can still hear the screams and whimpers of these sorry doomed souls. I guess we have often treated the mentally ill the same way Michael Vick and his friends treated their dogs. All this is very hard to accept, especially for a slightly spoiled 52-year-old writer sitting in her peach-colored study, tortoise shell cat sleeping alongside, while two maids clean the upstairs of her house.
Finally, in the 1960s de-institutionalization caught on and state mental hospitals gradually began to close in favor of community based care, the problem being there was no funding. Hence, a new trend - homelessness which evolved into today’s reality of the mentally ill being recycled through the hospitals and jails. Statistics are still bleak. According to the website for the National Alliance on Mental Illness (NAMI), approximately 57.7 million Americans struggle with a mental disorder each year—one in four adults. The U.S. Surgeon General reports 10% of children and teens in America deal with mental disorders that seriously undermine their daily lives. And finally, 90% of those who commit suicide suffer from a recognizable mental disorder.
When I first started working for the non-profit, many of my colleagues wondered how I was going to raise money for the mentally ill. My first response was always to ask if they or any of their friends or family had been depressed, if they’d known anyone treated for depression, been hospitalized for mental problems, or committed suicide. The answer was always silence.
Most of my donors had a personal connection with our mission to help the mentally ill. They had relatives or friends who grapple with mental illness so they already knew firsthand what it was like to live with this terrible diagnosis. My personal connection was through my husband’s Aunt Lizzie, a spinster great aunt who depending on whom you ask in the family was described as slow, retarded, or depressed. No one mentioned her name much. What’s kind of touching is we have her cookbook; a copy sits downstairs quietly in the den on a shelf next to our other ragtag much loved books.
Aunt Lizzie spent the last decade of her life at Piedmont State Hospital in Burkeville, Virginia. She was the youngest of five and grew up in a rambling Victorian home in Blackstone. As her sisters and brother died off, she went from home to retirement home and finally to the hospital in Burkeville, forgotten by all other than my mother-in-law who used to visit her on a regular basis, usually towing one of her children. The children dreaded the visits and my husband said he has blocked out most of the memories, though he said he remembered Aunt Lizzie vaguely; she was plump, dark haired, wore glasses, and looked like his first grade teacher, Mrs. Montgomery, “but when you’re little, all elderly women look like that.”
The cookbook is a snapshot of small town Virginia life: Blackstone, the 1930s. From the notes I know what Aunt Lizzie liked to cook and which recipes her neighbors shared with her. The title is My Better Homes and Gardens Cookbook and the cover states every recipe has been tested in their “tasting-test kitchen.” It’s a loose-leaf, much worn binder with an outside spine held with grey electrical tape. Many of the recipes are handwritten, typed, or cut out of newspapers and glued to cards. On an inside flap there is Lizzie’s signature and “This book was given to me by Anna” written underneath: a long ago gift from a younger sister. If you don’t hold the book carefully, watch out or recipe cards for Pickled Crab Apples or Mrs. Johnson’s Candy Chocolate Fudge may spill out.
Lizzie died around the same time my father-in-law had a massive stroke so the family was too distracted to focus on her. Six months after her death she was eulogized in a memorial service. In the end about the only legacy Lizzie left was the cookbook since all her possessions were sold off to cover her costs at Piedmont State Hospital.