In a Different Key: The Story of Autism (24 page)

The year after World War I ended, an institution became five-year-old Archie Casto’s whole world.

—

A
RCHIBALD
C
ASTO WAS
born in Huntington, West Virginia, on February 17, 1913. He was Herman and Clara Louise Casto’s fourth child, and also, they could tell immediately, their healthiest, most robust baby. He was also particularly beautiful. A mischief-maker as soon as he could walk, he was in motion all the time, poking into everything, wandering off the moment no grown-up was watching him. As a toddler, he started putting himself into dangerous situations, running toward fires, into the path of trotting horses, out into thunderstorms. His mother’s voice had no effect—he’d neither slow down nor come back when she called out to him.

By the age of three, when he still wasn’t speaking, it began to seem
plausible that Archie might be deaf—a devastating thought to his parents, as it meant a childhood of special schools and limited horizons later on, in terms of the jobs he could get and the families whose daughters would agree to let him court them. It was not a diagnosis Clara wanted to hear, but she was exhausted from trying to keep up with Archie and needed guidance on what to do. Clara set an appointment with the family doctor sometime after Archie’s fifth birthday.

When they returned from the appointment a few hours later, school was out, and their daughter Harriet was home. Harriet, who was thirteen years old, had never seen a look on anyone’s face like the one on her mother’s that afternoon. And she had never heard her mother cry so uncontrollably. Clara was shaking with grief, sobbing. Then Harriet learned why. The doctor had just pronounced Archie insane.

The next few days were difficult in the Casto home. Harriet, not fully understanding what was happening, became frightened when her distraught mother confided in her that “some things are worse than death, and this is one of them.” Her parents made a somber, silent trip to the courthouse, and upon their return, Clara told Harriet that Archie would be leaving the family to go live in another part of town. Harriet had seen the place, which had opened some years earlier on the eastern edge of town. Originally known as the
Home for Incurables, it was now the Huntington State Hospital. Surrounded by a high wire fence, with iron gates and a guardhouse controlling access, it resembled a prison, but it was officially designated an insane asylum by the state legislature. Commitment to the place required a judge’s approval, which explained the trip to the courthouse. The doctor had urged the Castos not to delay. The state agreed to commit Archie, a move that, in some of its practical implications, was like an adoption in reverse. Archie was broken off from the family, taken off his parents’ hands, and legally joined to the state. The Castos would follow the doctor’s advice—they would move on with their lives without a five-year-old insane boy in the family. The papers were signed, a bag was packed, and then Archie was gone, never to return again to a household that now had to figure out how to forget him.

Harriet was given the new rules of the Casto household where they
concerned Archie. She was never to mention him again to anyone beyond the family; she was to act as if she had no brother. Harriet was obedient. She learned to keep the secret.

Once Archie stepped through the hospital gates, he ceased to have a history. There would be no letters home, and he would make no friends to tell stories about his childhood later. No one would ever take his picture. The local school district never even opened a file in his name.

The thin evidence of his continuing presence under the institution’s roof appeared only once every ten years, when a federal census taker appeared at the hospital gate, and Archie’s name and age were recorded by law.
The 1920 census tables listed seven-year-old Archie as the youngest resident in a sex-segregated ward where nearly all the others were men in middle or old age. Now and then, at intervals spaced years apart, the local courts checked in on him, requiring that he be brought in for a personal appearance before a judge. These several minutes per decade were the only time an outside authority checked in on his well-being. One year, he was brought in wearing a woman’s coat, as if that were the easiest thing to grab for whoever escorted him that day.

At Huntington, each resident’s universe amounted mostly to the same two or three ward rooms: an area for sleeping, another for eating, another perhaps for pacing from corner to corner, behind windows screened with wire mesh. Archie shared these spaces, at all times, with dozens of other people. The doors, of course, were always latched—from the outside. These three rooms would be their universe, forever.

—

P
ARENTS WHO SENT
their children to institutions, who were usually following doctors’ orders, could only pray that the place chosen was not one of the “snake pits.” With sickening regularity, stories of the extreme neglect and outright abuse at many of these institutions broke out into daylight. Yet the outrage and indignation these stories stirred up almost always, with the same regularity, faded away fast, with little or nothing done to improve conditions. It was a scandal when the
New York Times
reported that attendants at the Western
Pennsylvania Hospital for the Insane were
“kicking and beating patients until they were unconscious,” denying them food, and controlling them by squeezing wet towels around their necks, “pulling at it until the breath is choked out of the victim and he sinks to the floor.” The dateline on this particular story was March 30, 1890.
It was a scandal again, thirteen years later, when the papers in Los Angeles gave coverage to nurses blowing the whistle on abusive practices at the Patton Institution, a mental hospital where women patients were allegedly disciplined for transgressions as minor as making faces or talking back to the staff by being tied under a heavy canvas sheet for up to three weeks at a time. Some, it was also alleged, were given injections of a compound that induced severe cramps and vomiting.

Another four decades after that, the nation was shocked anew when conscientious objectors, who had been forced to work in mental hospitals in lieu of fighting in World War II, came forward with photographic evidence of the wide range of atrocities they had witnessed inside the institutions. They saw men chained to beds, residents sitting naked in rows in their own excrement, and the use of beatings to keep order or simply to let off steam. They also reported that the wet-towel chokehold was still in use, half a century later. Some of the pictures became the subject of a 1946 photo essay in
LIFE
magazine, with accompanying text by Albert Maisel. Titled “Bedlam,” Maisel’s essay raged against these
“relics of the dark ages…concentration camps that masquerade as hospitals.” He lifted direct quotes from the conscientious objectors’ eyewitness reports that painted scene after horrifying scene. This one took place in New York State:

These four attendants slapped patients in the face as hard as they could, pummeled them in their ribs with fists, some being knocked to the floor and kicked. One 230-pound bully had the habit of bumping patients on the back of the head with the heel of his hand—and on one occasion had the patient put his hands on a chair, then [struck] his fingers with a heavy passkey.

Maisel took care to point out that not every asylum in America deserved his “concentration camp” label, though he insisted that most
were implicated. He also thought that the true bullies on staff were probably few in number, but that cruelty was inherent in the conditions that both residents and staff had to share together. “We jam-pack men, women and sometimes even children into hundred-year-old firetraps in wards so crowded that the floors cannot be seen between the rickety cots, while thousands more sleep on ticks, on blankets or on the bare floors.” Maisel reported that the decision to tie up patients or put them in solitary confinement was unwisely left up to badly trained and completely outnumbered staff members, who used last-resort methods too early and too often.

Each time stories like this emerged, it was as if the people on the outside were hearing it for the first time. After the 1946
LIFE
report, the needle twitched slightly on the meter of public outrage. Congress called hearings, and Maisel testified. Hollywood made a movie called
The Snake Pit
, which was nominated for nine Oscars, about a woman confined to a state mental hospital and the indignities she suffers there. In 1948,
Time
put
The Snake Pit
on its cover. “The large, hidden population of the mentally ill lives amid squalor, dirt and creeping fear,”
Time
roared, “behind the walls of the world’s indifference.”

As always, little changed in the aftermath. The institutions remained, and Archie Casto remained in an institution. It can never be known what sorts of abuse he personally endured, beyond what they did to his teeth. As it happened, however, a portrait of the very place he lived was put together by a newspaper reporter named Charles Armentrout, who wrote for the
Charleston Gazette
.
Armentrout snuck into the Huntington State Hospital in 1949, to report on what he saw there simply by walking its “wood-rotting room[s]” and “dimly lighted hallway[s].”

He was shocked by what he experienced. It is very likely that he saw Archie, who, at thirty-six, was by then one of the “lifers.” But it was the plight of the children that most disturbed Armentrout—children with nothing to do all day, with no toys, and with little or no clothing, covered in their own filth. Their lack of toilet training appalled Armentrout, and the resulting odor of the place—what he called the “odor of the mentally ill”—seemed to overpower him.

To Armentrout’s eyes, the wards looked like a sure firetrap. “Locked
up like common criminals,” he reported, “the girl [s] mentally deficient, like the boys, must find their play on the wooden, fire-hazardous corridor floor.” Elsewhere, he again referred to the “quarters of the youngsters” as “fire-trap structures.”

He was prescient. One cold November night, three years after his exposé, Armentrout stood on the grass of the hospital grounds looking up at the flames chewing through the female-only building, regretting, as he listened to the screams, that his story’s early warning had changed nothing. In fact, when his 1949 story appeared, six state legislators had banded together vowing to “provide needed relief.” But the effort led nowhere, and a spending bill to fireproof the hospital, finally approved in 1952, was dropped just before the fire broke out.

It started just before seven o’clock on the night before Thanksgiving eve, in the basement of a three-story building housing some 275 female patients—four times the population the architects had planned for. The mattresses were an easy feast for the flames. An eighty-nine-year-old woman was swallowed by fire, still tangled in her bedsheets, unable to rise. Those who were up and able to walk, however, could not reach the rickety spiral staircase on the back of the building, the only remaining escape route, because the doors of the ward were locked.

Their faces could be seen pressed against the wire mesh over the top-floor windows. Ladders were quickly raised and reached the windows easily, but then firefighters had to climb back down to get blowtorches to cut through the mesh. Once inside the building, firefighters ran from ward to ward, unlocking the doors, giving nearly three hundred patients a chance to run for it. Not all made it. In addition to Ada Carver, the old woman in the bed, another thirteen lost their lives that night. Five girls, all under the age of sixteen, were suffocated by smoke. One—
Lena Wentz—was only eleven.

Yet even this tragic fire did not bring about a reversal in the pattern of short memories and indecent neglect. In 1967, a new generation was stunned by a photo-essay published in
Look
magazine
exposing the appalling treatment of children and adults locked away in several institutions for the mentally disabled. Authored by Burton Blatt, an
educator; Charles Mangel, a journalist; and Fred Kaplan, a photographer, it was based on a book Blatt and Kaplan had published a year earlier with the unforgettable title
Christmas in Purgatory
.

Over the holidays in 1965, Kaplan had clipped a hidden camera on his belt, and he and Blatt had entered five different institutions. The photos, along with Blatt’s accompanying text, reported the same story that “Bedlam” had, twenty years earlier. It was the same “dirt and filth, odors, naked patients groveling in their own feces, children in locked cells, horribly crowded dormitories, and understaffed and wrongly-staffed facilities.” Blatt and Kaplan’s account provided still more evidence of the nation’s unthinking abandonment of the disabled, creating, Blatt wrote, “a hell on earth…a special inferno…the land of the living dead.”

“We now have a deep sorrow, one that will not abate,” Blatt wrote, “until the American people are aware of—and do something about—the treatment of the severely mentally retarded in our state institutions.” In accordance with the times, Blatt and Kaplan’s vocabulary relied much on the word “retarded,” but in all other ways they were pleading for a real break with the past. Before long, Blatt would conclude that the only answer was to close down the institutions altogether.

Still, the institutions remained, so that in 1972 they were discovered yet again by a young lawyer-turned-journalist named Geraldo Rivera, who reported his first big story by sneaking onto the grounds of a New York City institution called Willowbrook. Rivera became an overnight star partly for the way he communicated what television never captures. “I can show you what it looked like and what it sounded like,” he told his viewers, “but I can never show you how it smelled. It smelled of filth.
It smelled of disease. And it smelled of death.”

—

A
BUSE
,
NEGLECT
,
INDIFFERENCE
,
DEPRIVATION
—these were never consciously designed into institutional life, but they ultimately defined it. During his long life behind the walls, Archie Casto lost the little bit of language he once possessed. He failed to grow and pulled deeper inside himself. His ability to smile began to flicker out, and one day
simply disappeared. Now, his sister Harriet noticed, his face fell permanently into what she would think of as his “stony look,” an expression of pure hopelessness.