Ghost Stories

On a late October afternoon, I arrive at Harlem Valley State Hospital to learn what happened to my grandmother. The windows are covered with rusted bars; ivy creeps up the crumbling brick façade. Wind gusts send dried leaves whirling around the yards.

The hospital had opened as a state mental asylum in 1924. Its charter called for “the care and treatment of the insane.” The campus was huge – at one point 80 buildings sat on almost 900 acres of land. At its peak, it housed 5000 patients.

As I walk up a pathway of cracked stones, my hands are shaking. I’d begun this journey years earlier.

My grandmother’s psychiatric breakdown had long been a mystery. My father was six years old when his mother was sent to this place. He and his two brothers were told only that she was tired and had gone away to rest. In the 1930s, mental health was not something openly discussed. My father saw his mother only once more in his life – a painful hospital visit, when she didn’t recognize him.

Consequently, my sweet father had an outsized fear of fatigue. “Are you getting enough sleep?” he would constantly ask us kids. “If you don’t get enough sleep, you’ll get everything all ‘out of whack.’”

My dad’s description of his mother, Isabel, was idealized and frozen in time. He loved to remind us that she graduated Phi Beta Kappa from Barnard. I have her 1917 yearbook, “Mortarboard,” which portrays a girl steeped in college life. Isabel was active in the College Settlements Association – a group that worked with immigrants in New York City. She was class tennis champion. A member of “Wigs & Cues,” her name appears on several cast lists of student plays.

I know little about Isabel’s romance with my grandfather, just that they met through her older brother. After my grandparents married, they had three sons in quick succession. Isabel, unhappy with the education available in suburban New York, founded The Windward School, a progressive day school. My dad and two uncles were among the first class of students. (The school still thrives today, now focusing on children with learning disabilities. My grandmother’s portrait hangs in the entry.)

Isabel’s story then takes a radical turn. The year she turned 32, the energetic, compassionate, and beautiful young mother “got tired” and went away. Any discussion of her condition - vague murmurs of sadness- was discouraged.

Some six decades later, in the early 1990s, my younger brother Billy was diagnosed with schizophrenia. My father, who had always sensed Billy’s vulnerability, rashly promised his youngest son that he’d never be hospitalized. To Dad, hospitalization meant banishment, disappearance, and death.

Even so, my brother would endure multiple inpatient stays, most of them against his will. For decades, the cycle was relentless – psychosis, hospitalization, stabilization with medication, and release. My brother would soon decide he didn’t need medication, stop taking it, become psychotic, and he was off to the races again.

I remember visiting Billy in different locked wards, wire grating over the windowpanes, the smell of cigarette smoke, and the glazed look in my brother’s red-rimmed eyes. The sound of people wearing paper slippers, shuffling down corridors. The smoky TV room. No matter if the grounds had lush green lawns and beautiful oak trees or if the hospital was on a gritty city street, inside those psychiatric units were all the same.

My brother’s illness surfaced during a sweeping sociological move towards de-institutionalization of psychiatric patients. New medications allowed many people to live independently, and it was recognized that patients did better in smaller group settings than being warehoused in hospitals.

Many psychiatric hospitals were shut down, including the one where my grandmother had been a patient. When I learned it was closing, I wondered what would happen to all the medical records. Could I get my grandmother’s? Would they reveal what had really happened to her? I made inquiries and was told my grandmother’s next-of-kin had to request the records. Hesitantly, I approached my dad.

“You’re going to find out what happened to Mom?” he asked, a little nervous. But he quickly granted permission. What was he hoping for, I wonder? As I reflect now – years after my dad’s death – I think he wanted those charts to document her love. Perhaps some doctor’s notes confirming that Isabel never meant to leave her three sons.

A few weeks after submitting the request, a psychiatrist who was involved in decommissioning the hospital called me. He’d located my grandmother’s medical records. He wouldn’t send them. But he told me that if I drove to the grounds, the doctor would review the records with me personally.

He gave me detailed directions to his office. Once I arrived at the hospital, I understood why. It was easy to get lost on that sprawling campus. There were dozens of red brick buildings that differed only in their stages of disrepair. Inside, the hallways were dark, high-ceilinged, and mostly empty. Large cardboard boxes lined the walls. I was shown to a dim office – just one gloomy lamp to illuminate a half-packed room. The psychiatrist who met me was soft-spoken. He began by explaining how limited treatment options were when my grandmother was a patient.

The hospital had once been considered innovative, he told me. In 1936, a Viennese physician, Dr. Manfred Sakal, came to Harlem Valley to demonstrate his method of insulin shock treatment for the mentally ill, which would become standard treatment. Then in 1941, electric shock therapy was introduced. Doctors didn’t know much about how the brain worked, he explained.

I nodded, impatient. I didn’t realize he was trying to prepare me.

My grandmother had never recovered from her initial “break down,” he told me. Her diagnosis was “dementia praecox” – now known as schizophrenia. The state hospital had been my grandmother’s last stop. Her records showed that she’d been previously hospitalized at three different private sanitariums in the New York area and had also been sent to Johns Hopkins for evaluation.

The doctor first reviewed my grandmother’s earlier history. The file described her as “sensitive to injustice, hardworking, very efficient, apt to be tense and something of a perfectionist, with excessive drive in work and play.” Isabel, the records noted, was “passionately eager to be married, engaged only four to five weeks, with pregnancy taking place at once.”

The records noted that “her reaction to the children was an abnormal conscientiousness and extreme sense of responsibility for having brought children into the world. The inner drive which had always been present became intensified and her days were so crowded as to permit no period for relaxation. She was a devoted but detached mother.”

Her chart soon plunged into darker material. One entry noted that my grandmother was “anxious, fatigued, delusional, accused nurses of homosexual tendencies, attacked nurses and believes her food is poisoned.” She was also described as suffering from “pride and stubbornness.” It’s not clear if doctors believed these last two traits needed treatment.

A few years after she was committed, Isabel “talked about her children, the eldest and youngest different in appearance of the second [my father], jealous of woman caring for child, auditory hallucinations, assaulting nurse, talks in symbols, ceases to write letters, laughter, smirks, abusive to doctors.”

In the summer of 1937, she wrote to my grandfather, beginning with, “Dear Jake, for God’s sake, how long since I’ve been home? Have Grace [her sister] pack a bag. My devoted love to you and the boys....”

Her medical treatment can only be described as torture. She endured 16 treatments of insulin shock, resulting in “a severe reaction, marked by circulatory collapse, cyanotic, recovered.”

On some days after treatment, she was quiet; on others she’s described as “petulant.” One week, the medical record noted “marked improvement, walks on grounds, friendly, quiet.” Two weeks later, my grandmother was described as “relapsed, assaultive, noisy, required restraints.”

She was next given injections of a drug that induced convulsions. By the third injection, “patient showed improvement, friendly, more interested in family.” Isabel would be given 15 of these injections. One of them caused a severe convulsion, and my grandmother complained later of back pain. Her chart noted: “fracture – accident due to therapy.”

None of these treatments – including the one that broke her back – were curative. Her behavior was still described as “cyclical – calm, excitable, noisy at night. Patient claims ‘my recovery is not worth a candle.’”

In 1941, the doctors began electroshock therapy. Isabel had 49 applications, which the medical staff concluded had “little if any benefit.”

After all this, my grandmother – not surprisingly – deteriorated further. A doctor’s note in 1942, read, “Patient continues to require constant supervision. She is in restraints most of the day and night and sedated.” The following year an entry described “language vile, patient assaultive.” Four years later: “Patient continues to be the most difficult case in this building. Snarling, spitting, wetting, and soiling herself. Extremely dangerous to herself and others.”

By 1947 it took four attendants to control my five-foot grandmother, so they could place electrodes on her pre-frontal lobes.

Her condition, if possible, went further downhill, until the second week of 1955, when Isabel was given a powerful new tranquillizer, commercially known as Thorazine. For the first time in a decade, she was released from restraints and sat up on the side of the bed, able to answer simple questions.

Five weeks later she was dead of a heart attack.

The psychiatrist put the papers back in the folder and closed it. If my grandmother had gotten sick today, he said, her diagnosis likely would have been bipolar disease. She’d have access to meds that would’ve allowed her a normal life. The doctor probably meant this as a kindness.

I do not remember leaving the hospital. But I do recall sitting in my car in the now dark and deserted parking lot, trying to catch my breath. I had an overwhelming desire to suck my thumb, something I hadn’t done since I was three. I wondered if I was losing my mind. It runs in the family.

Have I mentioned how tenderhearted and sensitive my dad was? He couldn’t wait to hear what I’d learned about his beautiful, Phi Beta Kappa Mom. What did they say about her? My internal debate was short-lived. What good would it do my dad – then in is 70s – to know these things?

“Your Mom had the best medical care available at the time,” I told him. “She died peacefully.”

He was relieved. “I’m so glad,” he kept repeating. “I’m so glad.”

Later in life, when he got really old, my dad reverted to saying, “You know, my mom got tired. She had to go rest.”

Don’t forget my little brother. I wish I could tell you how Billy’s diagnosis and treatment illustrates the incredible progress we’ve made in dealing with mental illness. But that’s not how this story goes. The last time I saw Billy, he was in a psych unit, heavily sedated and convinced he had business dealings with a secret, elite group of German bankers.

Yet again, he’d been involuntarily committed, this time in North Carolina where’s he been living. My brother was pale and bloated; his body was marked with bruises, some deep purple, others faded yellow. Souvenirs, I believed, from encounters with the county sheriffs who’d responded to repeated 911 calls about my little brother’s behavior.

By this time, Dad was in his 90s and had dementia. He could remember little from one minute to the next. But he knew his kids. “How’s Billy?” he asked when I got back.

“Well,” I said, taking a breath. “He’s getting the best treatment that’s available.” This time Dad looked troubled. Over and over, he’d ask, “How’s Billy? How’s your brother?”

After that last hospitalization, Billy stabilized. He was attending a day program and taking his medications. But less than a year later, and at almost the same age as Isabel, Billy died of cardiac arrest.

Today I keep photos of both Isabel and Billy on my desk. The portrait of my grandmother is sepia-toned. She’s young and lovely, sporting a jaunty beret, hands tucked into fur muff. My brother’s picture catches him laughing. He’s about 16, with wild curly blond hair and pale blue eyes.

Now it’s me who needs to freeze them in time, keeping them young and healthy.

It’s been almost 30 years since Harlem Valley State Hospital closed. For a decade it stood empty. The property was a tough sell; the buildings contaminated with mold, lead, and asbestos. At one point, the grounds were sold to a developer, who announced plans to turn it into a luxury retirement village, with condominiums and private houses surrounding a golf course. But before even breaking ground, the developer sold it to a controversial religious sect, who ran a school on the campus. That, too, has closed.

Today, security guards patrol the property. The grounds have long attracted teenage vandals along with ghouls – the kind who take selfies on the old hospital mortuary slabs.

Of course, rumors have long abounded that the buildings are haunted. People claim they’ve seen ghosts among the weeds. I wouldn’t be at all surprised. Two of them are staring up at me from their frames right now.

Kate Stone Lombardi is a journalist and teacher. For more than 20 years she was a regular contributor to the New York Times. Her work has also appeared in The Wall Street Journal, Readers Digest, AARP Magazine, The Ethel, Dorothy Parker's Ashes and elsewhere. She teaches memoir inside New York State prisons.