Some days the news is so bad, circumstances so dire, or personal loss so devastating, I long for one of those old-fashioned health resorts, an open-air sanitarium from the days before psychotherapy mushroomed into the DSM (Diagnostic and Statistical Manual of Mental Disorders), a compendium of over 300 mental disorders, each with its own designer drug. Sometimes I long for a medical vocabularial regression, back to a time when, if you weren’t insane or suicidal, you were simply suffering from a case of ‘nerves’ and sent off to one of those calming retreats to regain your emotional footing.
Sanitariums (not to be confused with sanatoriums, medical facilities for treating tuberculosis) were prevalent in the US in the late nineteenth and early twentieth century, most in the Northeast. Several of them were a little too big for my taste—too many people, activities perhaps too micromanaged, bordering on cruise ships which seem to me like floating prisons of enforced gaiety. T. C. Boyle’s novel, The Road to Wellville, spoofed what was probably the most famous (and flakey) of them, the Battle Creek Sanitarium founded by Dr. John Kellogg. Kellogg was a Seventh-Day Adventist whose health notions seemed radical at the time but have since gained merit (except, perhaps, for his fixation with colonic hygiene). Another of those large sanitariums was the Jackson Sanitarium in Dansville, NY, known as “Our Home on the Hillside” where ‘granula’ was invented by Dr. Jackson in 1894.
I suppose my idea of a perfect sanitarium came from a much-loved Elia Kazan film, Splendor in the Grass, in which Deanie, played by Natalie Wood, is sent off to a sanitarium in Wichita to recover from a broken heart after breaking up with her boyfriend, Bud, played by Warren Beatty. The screenplay was written by American playwright William Inge, a native of Kansas, where the film is set. At the time, late Twenties, sanitariums were following the “milieu treatment” developed by the Menninger Sanitarium in Topeka. Milieu treatment replaced the old “rest cure” and was an all-encompassing approach, engaging patients in such physical activities as exercise, gardening or creative arts and involving all of the staff, from psychiatrists and social workers to housekeepers and gardeners, in a patient’s recovery. A decade later, all of this changed with the appearance of electroshock therapy, surgical lobotomies, and Thorazine.
In the film, we see Deanie in a landscape painting class and the young doctor she becomes engaged to, also a patient, making a metal sculpture. The building was like many of the sanitarium facilities of the time: inside and out, it could have been someone’s Victorian country home. The French doors of the visitors’ parlor opened onto a wide, columned veranda with white wicker furniture and beyond a spreading lawn dotted with old oaks and patients and nurses strolling or sitting in white Adirondack chairs. Everything was very slow, serene, quiet, the staff kind and attentive. Beyond the trees, there was water. Most all sanitariums had water nearby or on the grounds, either natural or artificial. The Wichita Sanitarium had a 1.5 acre artificial lake.
Of course, that was the movies, and Kazan who made even depression romantic. Still, there was some historic accuracy re amenities. A typical ad is this 1913 pictorial brochure from Dr. Givens’ Sanitarium in Stamford, CT: Located near the seashore off Long Island Sound, fifty minutes from New York City by train or steamboat, the grounds consist of 100 acres laid out in walks and lawns especially arranged for lawn tennis, croquet, baseball, and other out-door games. The residences, although described as cottages, were big and homey with long, white banistered porches and lushly landscaped lawns. A garden and orchard provided seasonal fruits and vegetables. There must have been cows and chickens because there were fresh eggs and milk daily. A walk followed the banks of a little river called the Rippowam, and several buildings had a commanding view of the Sound.
Some might say it would be depressing to be around so many depressed people, but I disagree. You might not want to stay for two and half years like Deanie, but what a relief to periodically be surrounded by a whole community of sad people. We live in a culture that does not know how to do sad. There is far too much emphasis on happiness. In a sanitarium, there would be no need to pretend when people ask, “How are you?” No one would presume: “You seem to be doing so well.” People mean well, they really want to know that you’re moving right along, but it can be exhausting trying not to disappoint them, like walking around with contracted muscles.
Writers seem to have a need for such facilities. Mclean Hospital in Belmont, MA, is known for its literary residents and was, for some, literally a last resort—Anne Sexton, Sylvia Plath, Robert Lowell and David Foster Wallace all spent time there. It was the setting for The Bell Jar and Girl, Interrupted. Sexton tried several times to get herself admitted and used to joke, “If only I could get a scholarship to Mclean.” Of course, these writers all had serious mental disorders, and McLean is a psychiatric hospital, not a sanitarium; but from its opening in 1818 until 1892, it was known as McLean Asylum and operated very much like a sanitarium with treatment stressing tranquility, a healthy diet and exercise regimen. As late as 1944, it was still a self-sustaining community, operating a farm, an upholstery shop and a blacksmith shop.
Robert Walser, a kind of W. G. Sebald of Switzerland, spent some twenty years in a sanitarium there. He did nothing creative in those years—he came there, he said, not to write but to be crazy—but kept busy at various jobs such as sorting and tying string for the local post office. He helped the nurses clean the ward, and in the afternoon, during the regular work shift, he gathered lentils, beans and chestnuts, or glued paper bags. In his free time, he liked to read yellowed magazines and old books. And he did write—microscopically small pencil handwriting now museumed as Microscripts and viewed more as literary oddities than literature. He could get five or six short stories on a postcard.
Louise Bogan, acclaimed poet and reviewer for The New Yorker for 38 years, spent time in 1931 at Cromwell Hall, a sanitarium in Connecticut much frequented by another poet, Sara Teasdale. There, Bogan found healing in weaving and concluded that, for her, time and fate were the things to be overcome, not only the irrevocable past but the inexorable passing of time, how fast it goes, how little one accomplishes in the brief allotment. She found peace at Cromwell; as Elizabeth Frank writes in Louise Bogan, a Portrait, her peace came not from “a passive resignation, but a willingness to live, work, and create as mortals within the confines of the finite.”
T. S. Eliot finished his most famous work, The Wasteland, while recovering from a “mental collapse” in a Swiss sanitarium in 1921. There, he broke through a serious writer’s block, an experience he later described in The Use of Poetry and the Use of Criticism as the “sudden lifting of the burden of anxiety and fear which presses upon our daily life…. Some obstruction is momentarily whisked away. The accompanying feeling is less like what we know as positive pleasure, than a sudden relief from an intolerable burden.”
Sanitariums had pretty much disappeared by the mid-Fifties following the appearance of the first antidepressants. Institutionalized treatment gave way to the consumer/survivor movement. Nowadays, the seriously ill can still go to a psychiatric hospital. Those with less money and/or health insurance are served by community medical clinics which identify a patient’s particular disorder then send him or her home with medication and instructions to call the doctor if they experience dry mouth or insomnia. For the merely sad, the nerve-frazzled, there is no longer an in-between facility like a sanitarium. It’s more or less a DIY project—self-help books, yoga, Tai Chi, meditation, herbal supplements, and, let’s face it, alcohol—you must pick yourself up and work your own way back into normalcy. Oh, you can spend a week or two at a spa where everything is done TO you—massages, facials, pedicures, mud baths—but, for me, the very fact of all that self-indulgent idleness would just make me feel guilty and more depressed.
For more solitude, you can still travel via cargo ship like Thomas Wolfe, who made seven trips to Europe between 1924 and 1936. Real freighters, not, as mentioned previously, floating carnivals. On them, expect to join a taciturn crew for dinner in the mess hall and help wash dishes afterward. Wolfe loved them but didn’t find them conducive to writing: I can’t write a good letter on a ship—the movement, the tremble of the engines, and the creaking of the wood destroy concentration. I’ll write later from Paris. A problem exacerbated, no doubt, by the poor quality of his writing instruments: This is not a tear—only a damn French pen.
Writer/artist retreats and monasteries offer some respite, kind of bare-bones versions of sanitariums. A poet friend goes regularly to a place in rural Virginia called The Porches, a historic farmhouse built in 1854 overlooking the James River. You’ll find solitude there, nature walks and porches, but no solicitous staff, no vegetable garden, no meals but those you prepare yourself in the communal kitchen. For more involvement in creative arts (and more money) there are week-long retreats. I have friends who teach poetry and painting at retreats in small villages in France and Italy. But not everyone at these retreats is recovering from a nervous breakdown; you might still have to put on a face. If someone reinvented the sanitarium, I think artists and writers would be flocking to it. When I explained sanitariums to a friend, she said, “Oh, where is one, I want to go. I could take sick leave.”
The dharma gods tell us we don’t have to travel to find peace. Lao Tzu in his Tao te Ching said if you are living right, even though the next country is so close that [you] can hear its roosters crowing and its dogs barking, [you] are content to die of old age without ever having gone to see it. Emily Dickinson was totally and happily insphered in her home and garden. Some go even smaller in their escapist models. Joyce Carol Oates, after the death of her husband of 47 years, made a kind of nest of her bed and lived and worked out of it for six months.
Siddhartha said do not seek peace outside yourself, peace is within. Buddha, too: the mind is everything; what you think you become. Writers, artists, musicians, creators in general, have a genetic predisposition to internality. They hide out in their compositions, worlds constructed to their own specifications. Proust did that, loved being in his imagined world so much he spent fourteen years completing it. Some go smaller still in essays, little forays into a subject that soothes. I can say honestly that I have spent several pleasant days and parts of nights in this one, eating granula and yogurt for breakfast, gathering beans and gluing paper bags in the afternoon, sitting on the porch at sunset watching the water change colors.
Maybe, as Louise Bogan found, a sanitarium is a necessary reprieve from time, but you can’t stay there indefinitely, because time is as inherent as oxygen—to wish to escape it is nothing less than a death-wish. So, good-bye, little sanitarium of the mind, where the rooms are light-filled and the gardens verdant, where all your ghosts meander the dirt walkways or sit on the blue-planked porch looking out to sea…sad, but resting.