“Somebody turned her in, but it whatn’t me.”

-Lydia’s Mother, “Lost in the City”

The titular story of Edward P. Jones’ Lost in the City ends with a peculiar anecdote. The main character, Lydia, recounts a story that her mother once told her of a crazy woman who was ultimately taken away to the mental hospital “St. Lizabeths” after someone turned her in for “twenty-five dollars and a pat on the back” (Jones 150).

Outside of the story, there is not a “St. Lizabeths” in DC, but there is a St. Elizabeths (not a typo: the institution has lacked an apostrophe in its name since it was accidentally left out of the founding Congressional bill), a prominent government-owned mental hospital still operating to the present day (Otto 30). In fact, the institution is mentioned a second time in the story “The Night Rhonda Ferguson Was Killed” as a location indicator for Gladys’s father’s house (Jones 43).

It’s not surprising that the location would be on Lydia and Cassandra’s minds: aside from just being around a really long time (it was founded by the government in 1855), at its founding St. Elizabeths was only the second mental institution in the United States to serve Black patients (Otto 38). While it may have been progressive in this regard, the early hospital was still hardly tolerant. Patients were separated by gender and severity of condition, but also by race, and the bunkhouses for Black patients were clearly inferior: built with cheaper materials, more simplistic architecture, and housing many more people together in one room than the relatively private white buildings (Otto 38-39).

Progress towards equal treatment of Black and white patients was slow. St. Elizabeths’ initial purpose was to serve the citizens of DC, alongside members of the army and navy, and while severe overcrowding during the civil war did result in some Black soldiers being housed with white, the practice of segregation was still firmly in place until the 1950’s (Otto 33, 271). By 1954 things had changed slightly, as the hospital’s administration officially ended its policy of racial segregation. However, no steps were taken to break up the patients’ current housing arrangement, so in practice the system remained in place for multiple more years (Otto 271).

The moral practices of St. Elizabeths were a mixed bag. While the institution was built in response to Dorthea Dix’s push to end the abusive treatment common in mental institutions at the time, it occasionally became what it sought to prevent (Otto 3). The hospital’s patients were regularly put to work to keep them busy. While this was not technically required, they were bribed with lunches (Otto 138). It is unclear if the patients still got lunch if they didn’t work, but even when they did receive their meals, the quality was poor. The hospital’s first superintendent was driven to resign by accusations of, among other things, feeding spoiled food to the patients (Otto 62). Later reports found evidence that the hospital’s staff would provide unusually high quality food and clothing the day of inspection, before going right back to neglect when the health inspectors left (Otto 220). Other instances of abuse were more physical, however, as in the case of John Overton. Overton was a Black patient who stayed at St. Elizabeths for ten years until 1917, when two attendants killed him with a baseball bat after he refused to get dressed in the morning (Otto 212).

This is perhaps the kind of treatment that would give the hospital such a sinister light in the eyes of Lydia’s mother. There does not appear to be any officially documented evidence that St. Elizabeths paid people to turn in unwilling patients, but then, the hospital did receive funding per patient, and after 1946 the hospital stopped admitting military patients outside of the coast guard (Otto 270). This circumstance, combined with the new influence of tranquilizing drugs, dropped the hospital’s population drastically from its former perpetually overcrowded state, and there are records of the staff at the time actively attempting to recruit more patients to make up the difference (Otto 270).

In any case, by the 1960’s, innovations in mental health treatment procedures had radically shortened the average hospitalization time of patients, and St. Elizabeths voluntary admissions were at an all-time high. The eventful history of St. Elizabeths reflects and amplifies the generational differences between Lydia and her mother, who would have known very different versions of the institution in the times that they each came into adulthood in Washington.

Work Cited

Otto, Thomas. St. Elizabeths Hospital, a History. Washington DC. United States General Service Administration. 2013. Print.