Damnation Island, by Stacy Horn

It’s an old saw that the measure of a society is how they treat it’s poorest members. If this is true, then nineteenth century New York has a lot to answer for. As we learn in Stacy Horn’s Damnation Island: Poor, Sick, Mad, and Criminal in 19th-Century New York, being poor and/or suffering from a mental illness and/or being a criminal at this time and place meant a trip to Blackwell’s Island. The island was home to an insane asylum, a prison, and a work house from the second half of the nineteenth century into the early decades of the twentieth. Horn dug through archives and newspapers to tell the appalling stories of all of these institutions.

The first third of the book covers New York Lunatic Asylum. Nineteenth century mental health care was appalling compared to today, though I suppose this asylum was a step up from London’s Bethlehem Royal Hospital (Bedlam), where keepers would charge admission for people to see the patients. The rooms at the Lunatic Asylum were essentially cells—small, dirty, and overcrowded. As a special bonus, the attendants were inmates from the nearby Penitentiary and the doctors were undergraduates, sometimes in their first year of medical school. The place was a miserable hell on earth. It was so bad that it was the subject of one of journalist Nellie Bly‘s exposés. Even though there were calls for reform, nothing ever happened for the patients. They were poor and there was never enough funding to build them something better.

After discussing the Asylum, Horn moves on to the Penitentiary, the Work House, the Almshouses, and the island hospitals. The situation at these buildings was dire. Hundreds of people would die in epidemics of cholera or typhus. Hunger was endemic. But I think, even worse than the deprivations of the island was the attitude of the people in charge of the island’s institutions and its funding. Even though the idea of all of the island’s institutions was to provide a place and care for people who had no where else to go, costs were cut everywhere. At one point, one of the buildings was literally bolted together before it fell apart and had to be rebuilt. Pennies were pinched because, as Horn quotes from the annual report for 1876, which reads:

Care has been taken not to diminish the terrors of this last resort of poverty [the Almshouse], because it has been deemed better that a few should test the minimum rate at which existence can be preserved, than that the many should find the poor house so comfortable that they would brave the shame of pauperism to gain admission to it. (n.p.*)

Horn also quotes Alexander Macdonald, a physician who worked at various of the island’s hospital, who wrote, “To be sure some of them will die, but so much the better for the tax-payers!” (n.p.). He was writing sarcastically but, given the attitudes of the commissioners in charge of the island and philanthropists like Josephine Shaw Lowell, he was essentially telling the truth. They are some of the most hard-hearted people I’ve ever read about.

Last year, I read a history of Bellevue Hospital, which overlaps the history of the New York Lunatic Asylum. Bellevue was and is a charity hospital that treats anyone who comes through the doors. They suffered from some of the funding issues that the Blackwell’s institutions did, but there is a fundamental difference between the two—at least the way the authors present it. There were people who cared at Blackwell’s, just not enough and with not enough clout to fight back against the commissioners. Where Bellevue could triumph in the face of adversity, Blackwell’s just stumbled along, drowning in people they couldn’t help.

Damnation Island is a fascinating, albeit depressing, look at what Americans did to house their poor, their criminals, and their mentally ill instead of caring for them. The prevailing beliefs that these people deserved the terrible conditions that they suffered on Blackwell’s were working against them even before they got off the ferry. Reading this book made me wish things were better today for poorest among us, but I take a little bit of encouragement from the fact that we no longer ship them off to a wretched island.

I received a free copy of this book from the publisher via NetGalley, for review consideration. It will be released 15 May 2018.

* Quotes are from an advanced reader copy without pages.