Nostalgia
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Lost Patients is about serious mental illness. This episode mentions rape and suicide and includes descriptions of surgical procedures, so it might be disturbing for some listeners. One day, three generations of women rode through Seattle in a car, trying to help one of them remember. Carrie Davidson was in the backseat. Carrie's mom was driving.

And in the front passenger seat was Carrie's grandmother. My grandma has dementia. She just turned 95. We had taken her out, driving her around Seattle, like to the places where she used to live, just trying to jog her memory and get her talking. Something came up about my grandpa. And I said, "Gosh, I wonder what his mother's name was." And she pipes up in the front seat. She sits up. She goes, "Lillian Massey." And I was like, "Okay, didn't—I had never heard that name before."

Lillian Massey, Carrie's great-grandmother. With that recovered memory, suddenly a fourth generation of Carrie's family appeared in that car. For Carrie, it was a revelation. Carrie knew her grandfather had been adopted, but it was so long ago, in 1925, she didn't think she'd ever know who his birth mother was.

He struggled with alcoholism when he was alive. His kids struggled too, in different ways. As if an unhealed wound was passed from one generation to the next. Carrie thought knowing more about Lillian and why she put Carrie's grandfather up for adoption might reveal where that wound came from. I was like, I'm going to find her. And so I joined Ancestry and started looking. And I found nothing. Nothing, nothing. Nothing.

I searched for her and it kept kicking me over to another website and it pulled up her death certificate. They had what I had never been able to find and that was like our first substantiation. She was a living, breathing person and she died in January of 1934. And it said that her death place where she lived was Northern State Hospital. What the heck is Northern State Hospital?

Cary would soon learn Northern State Hospital is tucked in a lush valley encircled by gray mountains a couple hours drive north of Seattle. For more than half a century, it was a psychiatric hospital, but it's been abandoned for a long time, closed by Washington State in 1973. Before then, tens of thousands of people passed through this compound, many of them from Seattle. Thousands died here. Today, it's mostly a ruin.

Northern State Hospital is how psychiatric care used to look in the U.S., sprawling campuses of ornate buildings where people spent years or decades under the care of psychiatrists and nurses employed by the state government. At one point, at their peak, half of all hospital beds in the U.S. were in these institutions. This is the memory that hangs over the system we have today like a shadow.

So much of what we've built in the past half century is in reaction to hospitals like Northern State. The answer to the question of why people in mental health crises today get lost, this is where it starts. When you talk to people today about these old psychiatric hospitals, you get one of two responses. One is that these were hellholes. Patients were warehoused, neglected, forgotten, abused, experimented on.

and we were right to shut them down. But these days, you also find people who are nostalgic for these asylums. Because at least there was somewhere for the most seriously mentally ill people to go that was not the streets. At least the state took responsibility, real responsibility, for their care. For Carrie, learning Lillian's name in the car that day sent her on a journey that lasted years.

She started hunting down every scrap of information she could find that could help her imagine what her great-grandmother's life was like at this asylum in the valley. I've done research, like, what kind of underwear did they have? And, you know, just, I don't know what they wore in the 20s, you know? I've just, I've tried just looking up as much as I can to figure out what it was like for her. At the heart of Carrie's search is a question.

When we look back on the era of psychiatric hospitals, which memory is true? The nostalgia or the horror? And if we get the answer to this question wrong, will our lack of understanding doom us to make the same mistakes over and over? I'm Will James from KUOW and The Seattle Times. This is Lost Patients, Episode 3, Nostalgia.

Broken glass and graffiti and wood that's been rotted through. Sydney Brownstone, an investigative reporter for the Seattle Times, spent the better part of a year digging into northern states' history. We walk through crumbling farm buildings where patients once tended dairy cows. Blackberry vines spill in through cracks and spread over entire buildings. You can see sunlight coming in through the rafters where the roof has...

kind of partially collapsed. Down a path, we get to the locked wards where patients used to live under crumbling terracotta roof tiles. The cemetery at Northern State looks like an empty field where many of the stone grave markers have sunk into the waterlogged earth. The stones don't have names on them, just initials and numbers. To Sydney, this field lies like a symbol of how we've treated the memory of this era of psychiatric care.

This space, this cemetery, made it hit home for me because my family's Jewish. And so a lot of family vacations were to Jewish cemeteries. And the message was always, remember, history must be remembered so we don't repeat it again. And so walking into a cemetery that looked like a bunch of molehills with no kind of identification of the people who died here,

just seemed like this massive lost opportunity and an indignity. Sydney started trying to uncover the stories of patients lost in the ruins of Northern State. And along the way, she met Carrie, who had already partially filled in the missing history of her great-grandmother's life.

Carrie had negotiated with Canadian archivists, talked with a lawyer about how to obtain 100-year-old court records, and tracked down a distant cousin in Canada who could tell her more about her family's history. What emerged was a story of how Lillian ended up at Northern State Hospital. You can turn the light on. Oh, I wanted to ask about this box. Oh, it's right here. At Carrie's house, she shows Sydney a display case full of memorabilia she collected during her search.

In it, there's a black and white photograph. That's Lillian. That's Lillian. We're not sure where it is. It looks to me as if it's like a train depot or something. Very nicely dressed with a watch and a necklace and holding her hat. She's squinting because there's sun on her face and she kind of has this confused expression. It's hard to tell what she's thinking. She looks a little bit just...

spaced out, and it's dated January 1925, which would have been right around the time she was institutionalized. Everybody who knew her in life, of course, is gone because she was born in 1900. But what I've learned since then is that she was just thrown away. Carrie found records showing Lillian was raped as a 15-year-old in Canada, and the man who raped her later married her. They moved to Washington state.

And it was this same husband, this same rapist, who sent Lillian away to Northern State Hospital when she was 24 years old. They had two young daughters at the time, and Lillian was pregnant with their son. Lillian had syphilis, a sexually transmitted disease that affects the brain if it goes untreated. Carrie suspects Lillian's husband gave it to her.

We've got a nursing program where I work, and so I called up the head of the nursing program, who's a friend of mine, and I'm like, this is going to sound weird, but what does untreated syphilis do to your brain? And she said, it eats your brain. It's terrible. And so I explained to her why I was asking, and she said he destroyed her. He didn't want her and threw her away. There's not a court order on file, but back then there didn't have to be.

I've read records that women were there for menopausal hysteria. It's like, are you kidding me? Really? You've gone to great lengths to find her. What drives you? He destroyed her. And she had nobody to speak for her. She had no voice. She had no rights. And she was real. She lived. And if it wasn't for her, I wouldn't be here. And so I think that it's important for people to know

We've already heard how today, a lot of families and politicians say it's much too hard to involuntarily commit people to psychiatric hospitals. The reason is that back in the Lillian's time, and for decades after that, it was much too easy. Husbands could disappear their wives to these places without raising too many questions. Institutions like Northern State filled up not just with people we think of today as seriously mentally ill, but also with people who were

but also with immigrants who didn't speak English well, gay men, lesbians, the elderly, those who were rebellious or just didn't fit in, who others found inconvenient. And once someone was there, they sometimes never left. She spent the rest of her life there, and she died there. She died January 28th of 1934, pulmonary tuberculosis, after nine years and two weeks spent at Northern State University.

Lillian was 33 years old. Carrie had learned a lot about her great-grandmother, but those nine years and two weeks were still a blank space, a third of Lillian's life. When Carrie drove out to the Northern State campus, she walked through the fields buried in towering blackberry brambles. It was like, well, gosh, I wonder if

She was one of the people that did berry picking for making jam. And she peeked inside the rooms where violent female patients were once locked away. I did get that kind of pit of your stomach kind of feel. And it's like, oh, could she have been there?

She was kind of flipping back and forth between these two imagined realities of Lillian in Northern State. And one of them is, well, these grounds are beautiful. Maybe my great-grandmother was out picking blackberries and she found a sort of respite away from her horrible husband. Maybe this was a really good place for her to be. And then the other vision is there's my great-grandmother screaming behind a locked door.

Meanwhile, Sydney searched for Lillian in Washington state's archives. She got access to patient records that the state had sealed away for decades. It is 4:04. I have 26 minutes until the state archives office closes and I have a folder of ward reports from patients.

It's in a red folder because it used to be restricted, but I guess now it isn't. And it's sealed, so I'm going to open it up for the first time. Oh, wow. I don't know what year this is from, but it's the names of all the patients and the patient numbers with their diagnoses. Sydney flipped through brittle onion skin paper, hoping to find Lillian's name in these records. But as she searched, another picture took shape.

A picture of a hospital built on contradictions. Support for NPR and the following message come from Edward Jones. What is rich? Maybe it's less about reaching a magic number and more about discovering the magic in life. Edward Jones Financial Advisors are people you can count on for financial strategies that help support a life you love. Edward Jones, member SIPC.

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Big news stories don't always break on your schedule. But with the NPR app, news, culture and podcasts are ready when you want them in your pocket. Download the NPR app today. Sydney says, like so many things in the U.S., Northern State Hospital started as a business plan. Washington State needed a new psychiatric hospital to relieve its two existing ones, which were under strain.

In the town of Cedro Woolley, in the valley north of Seattle, it needed jobs and tax revenue. This small farming community, Cedro Woolley, barely had roads. Its business people were constantly getting together and trying to figure out ways that they could have more infrastructure and business and development. And the

And the town's leaders figured, well, why don't we advocate for having an institution here that would give people jobs? It was kind of part of the town's economic development plan. Siddra Woolley is where Washington state built its new psychiatric hospital. At this point in the early 1900s, a reform movement had already been sweeping the U.S. for decades.

The movement was to take seriously mentally ill people out of the poorhouses and almshouses where society had abandoned them in squalor and put them in a new type of setting where they could heal and return to society as workers. This new model was the psychiatric hospital.

Northern State was founded on this idea of occupational therapy, this notion that if you are given work to do, like on the farm or in the dairy, in the laundry, you will develop better mental hygiene and then be able to return to society. It was a very hopeful time.

So the state hired the son of Frederick Law Olmsted, who designed Central Park to design the grounds. Central Park in New York. Yeah. Yeah.

I mean, the buildings themselves look like they could be Tuscan villas or something. So they have these beautiful terracotta tiles. You have these neatly manicured lawns. This was done very intentionally for the purpose of healing. It was this idea that people exposed to this environment would benefit from it, but...

You know, some historians and experts say that it had a double purpose. It also served to make people outside the institution feel better about what was going on inside of it. Because how could anyone be mistreated? It's so lovely. You know, the buildings are so beautiful. These grounds are so beautiful. There was one other intention built into Northern State from the outset.

The hospital's first superintendent, in his initial report to state lawmakers, wrote that Northern State would be the, quote, most beautiful and profitable institution the state had ever seen. And I stopped at that sentence. I was like, profitable? How could anyone ever think that a public health program was going to be profitable? I think ultimately they were thinking that this was an institution that was going to pay for itself.

Northern State took in income from families paying fees to house patients there and from a farming operation that included a prize dairy herd.

But soon, that vision of profits crashed into reality. The cities and the counties that had almshouses or poorhouses full of people with mental illness, people with dementia, alcoholics, they said, OK, finally we have a place to send them. The state's going to take care of it. It won't be our problem anymore. And so these institutions became the magnets for all the...

social undesirables from everywhere else surrounding them. Northern state filled up. Records show hospital superintendents pleading with state officials for years to build a tuberculosis ward to stop the deadly disease from spreading through the campus. As the dream of profits faded, so eventually did the idea of an idyllic farm where patients found meaning in working the land. The focus shifted to curing them as quickly as possible to make room for more.

In the 30s, doctors at Northern State and around the country started trying new treatments based on their mistaken belief that all mental illness came from bacteria. They removed patients' thyroids, appendixes, and tonsils, hoping to eliminate the sources of their illnesses. This was around the time that they figured out that

syphilis caused brain lesions, which created psychosis as a symptom. So they thought, okay, well, if there's a biological origin for this type of psychosis, maybe all psychosis or all mental illness has some sort of biological origin. They deliberately infected patients with malaria, thinking a fever could wipe out mental illness.

And then there was a common practice called hydrotherapy. It sounds like it would be on a spa brochure now, but people were subjected to long, sometimes hours-long baths in either cold or really hot water, and it was not at all pleasant because they were restrained there.

Eventually, the pressure to cut costs led to eugenics. Sidney found evidence that between 1935 and 1940, northern states doctors performed at least 100 sterilizations on patients, vasectomies and bilateral salpingectomies, which meant removing the fallopian tubes. Each bit of paperwork for a sterilization read the same. It said...

Each patient had the potential to produce offspring who, because of inheritance of inferior or antisocial traits, will probably become a social menace or ward of the state. So it was also very blatantly a cost-cutting measure. They said, we don't want more people filling up our institutions in the future, so we need to sterilize people now.

I came across the sterilization of a 15-year-old girl who, you know, when the doctors are writing about her behavior, they say she had become wayward in her appearance. They wrote that she had fallen behind in school. And her father requested that they take out her appendix while they were in there. It just seemed really cavalier. While this was going on, Northern State fielded a baseball team, the Hospital Stars, made up of staff and patients.

and the campus published its own newspaper, the Northern State Hospital News. As Sidney sorted through Northern State's contradictions, she honed in on a particular decade, the 1950s. It was the heyday of psychiatric hospitals around the country, the decade that formed many of our national memories of these institutions, when One Flew Over the Cuckoo's Nest took place. Back then, psychiatric hospitals housed more patients than at any other time in history.

Northern State peaked at around 2,200 of them. Sydney wanted to talk to someone who was around in the 1950s, who witnessed Northern State in full swing. In a book about the hospital, she found the name of a nurse who used to work there, Joanne McInnes. I interviewed Joanne in her room at her assisted living facility, and she is just as sharp as a tack.

Honestly, I was hoping she would just kind of give a detailed description of the place when it was at its peak, but the interview kind of took its own course, and she ended up reflecting on...

the morality or the ethics of her participation in some of the treatments back then. Joanne's now in her 90s. Back in 1954, she was just out of nursing school. I decided I wanted to go to Northern to work. What were your first impressions of the place? I'm going to close my eyes. After you came off of the highway, there was a gate. As I remember, it was brick and cement.

and it was arched and it was rather narrow. Driving up to Northern in this beautiful driveway, I was scared to death. It was beautiful grounds, everything, but I had no knowledge really of mental illness.

And of course I knew in the back of my mind, you know, all these things that I had grown up with, with people saying "Bughouser" and negative remarks. "Bughouser" refers to someone in a psychiatric hospital, which people called "the Bug House." Joanne remembers reaching over and locking the car's doors. And then she passed housing, farm buildings, a print shop, laundry,

The campus had its own electric plant, its own logging operation. It was a self-contained mini-city. Joanne says the fear she came in with didn't last long, once she became part of this place and started working with patients. When you were there, who was coming in? I mean, what kind of people were you seeing? Very sick people. And scared, you know. They were admitted, they were so scared.

or they were fighting because they were scared. Seventy years later, Joanne is still wrestling with what unfolded at Northern State. This message comes from NPR sponsor, Ooni, introducing the Koda 2 Max, their biggest and most versatile oven yet, with two powerful, independently controlled gas burners for side-by-side, dual-zone cooking at a range of temperatures.

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Waylon, how much do you think it would cost to buy one of those big digital billboards in Times Square to promote our show, the indicator from Planet Money and Big Lights? In this economy? I mean, you're probably right. But this question is the exact kind of thing that we find answers to on our show. We take one big economic idea, make it understandable and, you know, even fun. That's the indicator from Planet Money and NPR.

Around the time Joanne McInnis was starting as a brand new nurse at Northern State Hospital, a man named Louis Emmett Scholl was admitted there as a patient. He went by Emmett. He was a carpenter, a religious Quaker from north of Seattle, married with two kids. So, I mean, to get started, could you just say your name and the very basics of who you are? My name is Merlyn Rainwater. I grew up in the Seattle area.

And I think what's relevant for this context is that my father suffered from intermittent spells of mental illness. And while I was a child, spent two lengthy periods of time in Northern State Hospital. My memory is that we visited with our dad on the grounds, which were pleasant, but there was just this atmosphere of sadness.

I don't know what you'd call it. It just, it felt hollow somehow. There was, I have a photo, my brother and me and my dad sitting on a bench when I was probably 12 and my brother was 10. And we just look kind of shell-shocked or something, just very stiff and awkward. And my dad was medicated and

So he was more restrained than we were used to, and I think it was very strange. Just a few months ago, Merlyn was digging through papers left behind by an uncle who had died and found a letter her dad Emmett had written to a friend a few months after his first stay at Northern State.

Emmett writes, "My first recollections of Northern State Hospital are of finding myself in a bare but clean hospital room and wondering how and why I was there." He writes about good times he had at Northern State, bonding with other patients, reading issues of Reader's Digest to a blind young man in his ward. Emmett liked working in a carpentry shop on the campus so much that his constant whistling got him in trouble with a foreman.

There was a doctor he really liked, Dr. Strati, who seemed to care about the patients. Then there was Dr. Newkirk. I don't know if your dad was trying to be funny, but it's also very funny to read some of this. Like when he talks about Dr. Newkirk on the third page, or sorry, it's the fourth page, the third paragraph down. Oh, sure. No, my dad had a great sense of humor. Yeah, that's what it says.

Dr. Newkirk was attended by a young intern who seemed to me to be still dripping behind the ears. I was keenly aware of Dr. Newkirk's air of cynical superiority, and I felt that he was trying to impress both the young intern and myself that his great intellect and wealth of experience could permit him to do no wrong. Emmett writes that one day he knelt and prayed at his bedside and said a few words out loud to himself,

He knew his behavior might be relayed back to the doctors as a sign his mental illness was still uncontrolled. But in that moment, he didn't care. The next day, he writes, "There was something in the air. The atmosphere of the ward was silent and tense."

"There were perhaps six of us," he writes, "who were scheduled for shock treatments that day. None of us knew why or what the treatments were supposed to do for us, but it seemed to be the general feeling that these treatments were some kind of punishment for those patients who had not learned to fall in line with the run of the mill. We were lined up in straight-back chairs in the middle of the juvenile delinquent ward, with some of the toughest-looking attendants in the hospital standing by.

Emmett's writing about electroconvulsive therapy, ECT, which is still in use today. It works by causing seizures that can quickly and profoundly give patients relief from symptoms of depression or mania that don't respond to other treatments. But today, the patient opts into it and is under anesthesia.

Emmett, back in the 1950s, did not get anesthesia or choice. He's talking about the electroshock treatments on page five. He says, I wondered how this sort of treatment could possibly help these good-looking kids and their teens to readjust to life in a society that had never yet been willing to accept them. Mm-hmm.

Was the whole thing designed to turn out just thoughtless automatons, incapable of crying out or standing up against injustice? Were we all to become pawns of a heartless, mechanized society owned and operated by a totally military regime? No, no, no, my whole being cried out against the thoughtlessness and carelessness that could create such agony and eventual emptiness in the hearts of men.

Emmett goes on, quote,

I was soon strapped securely to the bed. The current was turned on, and everything went blank. I came to with a terrific headache. I felt beaten and numb. The inside of my mouth and the back of my throat felt raw and sore from having the padded electrode jammed into my mouth against my will. Well, I had lived through the ordeal, but I wondered how much more of this sort of treatment I could take without going completely haywire.

Emmett goes on to write that after these ECT treatments, he never found any enthusiasm for his work in the carpentry shop again. He'd sit and not do anything until he got specific orders from the foreman.

What do you think the goal was for your father's treatment at the time when he was hospitalized? I guess the goal is to get the person in a state where the rest of the world can interact with them in a predictable manner. Another treatment from this era was insulin coma therapy. Patients got heavy doses of insulin for days on end, sending them into a coma.

The idea was that when they woke up after these comas, their symptoms would improve. Like trying to hit reset on a person. Joanne, who was a nurse back then, says this was a treatment she helped administer. There were like five to eight young women in that program. Probably the majority was schizophrenia. What was the thinking behind the insulin comas? What was the belief that this would help?

I don't think they really knew, but I think it was just a way of control. I had a lot of doubt about what the insulin coma therapy was doing. I think what helped mostly with that was the attention that they got. They were treated differently. They had more one-to-one experience. They were taken on walks, for instance. You know, there were things planned for them after they would...

complete the therapy in the early morning. So I think that was beneficial. But what happened to him later, I've often wondered. Did you ever lose a patient? Yes, yes. Lost one in insulin coma therapy. It went into an irreversible coma and she died.

Joanne says some of the doctors prescribing these treatments were like little gods of the campus. There were few protections for patients, so if a doctor wanted to launch an experimental treatment and try to make a name as a pioneer, they could. I can remember one test that didn't amount to a hill of beans as a result of what they found, but it was called the Funkenstein test. The Funkenstein test.

This is what Emmett had to pass to get released from Northern State. He wrote about it in his letter. I googled it because it sounded so bizarre. And it's a real thing. I'll just read it. The toughest thing I can remember during that last week was the so-called Funkenstein test. Dr. Strati was careful to explain to me that it was designed to test the reactions of the body's defense mechanisms.

I was glad to see that Dr. Strati was able to be present and that he maintained a prayerful attitude during the test. They first injected some adrenaline into the bloodstream, making me feel very warm and causing me to breathe hard, as if I could hardly get enough air. At first it made me feel lightheaded and almost as if I were floating. Then I felt sort of let down for a short time, but soon was back to normal again. Dr. Strati said I passed the test with flying colors."

It's just pure hooey. And on what basis did anybody ever think that you could, you know, diagnose mental stability by injecting somebody with adrenaline? And it's just the fact that Dr. Strati is maintaining a prayerful attitude. Like he knows that this is not a pleasant experience for the patient, but he has convinced himself that this is somehow useful.

Probably the most extreme example of doctors convinced about the necessity of a brutal treatment was the lobotomy. About 50,000 patients around the U.S. went through this surgery before it fell out of favor in the late 1950s. But when Joanne started at Northern State, they were still going on. At the time, lobotomies were done only with

My only experience was with men and they were out of control with their behavior and somehow they felt that medication that was available at that time was not working for these people. And so in order to control their behavior, they would destroy certain parts of the frontal lobes.

And it was not a nice scene. The person was given an ECT or medication, and it was done in a surgical suite. This is my experience now. At first, Joanne did not want to describe this procedure because it's so graphic. But after a conversation with Sidney, Joanne agreed it's important to share the details of this history so we don't repeat it.

Joanne described a transorbital lobotomy like this. A doctor would take two instruments, they look like ice picks, and insert each into the eye socket and punch them up into the brain. The doctor would then wiggle the two instruments back and forth, side to side, and the more you wiggled them, the more brain tissue they would destroy in the frontal lobes.

Joanne says a TV news program aired an image of her in one of these surgical suites where lobotomies happened. It was a period of glowing coverage for lobotomies. There was even a story in the Seattle Times about the early successes of these procedures. But this is a complicated memory for Joanne. It was emotional. Yeah, it was. And then I took care of the patient afterwards. You know, and there was a lot of bruising. And you hope that what you're doing...

is correct and is helpful. But you can, you know, have a lot of questions about it. You tried to have faith, you know. What did you learn from your time at Northern State? That's an interesting question. I learned so much about human behavior. To really listen, to be more patient. I felt loved there. What were the rewards for you? A patient coming up and saying, "I want to thank you."

You listen to me on a particular day or a smile or a touch. You have to know when to touch and when not to. In mental health nursing, you know, your rewards are very slow to come. And when you got one, it was really gratifying. It just really strikes me that the positive memories people have of Northern State are

are about personal interactions, working the farm, staff getting to know patients and patients getting to know each other. And the bad memories people have of Northern State are about the medical treatments and psychiatry. Whether it's Joanne, a nurse, Emmett, a former patient, Carrie's impressions, you know, it just seems like a pattern. Yeah, I mean, to the extent that

people took care of other people. Care, in the most basic sense of the word. We can look to these institutions as places where care was received, and that's a good thing, right? But then we look at the field of psychiatry and what constituted treatment. It was ultimately, as Joanne says, to control people, to sedate them, and sometimes it was done through very violent and cruel means. It's like...

at places like Northern State, there were different motivations. And one of those objectives was to really care for people, give them a beautiful place to find meaning and purpose. And another of those objectives was to control people's behavior, to fix them, to make them suitable for society again. And like,

If you're not paying attention, those two objectives can sort of seem like the same thing, but they're really not. And that's where you get these like very different experiences of northern states history. And the third objective, too, was to save money. Ultimately, one of the things I think about with institutions is like, what are your inputs when you're creating these places? Right.

If your inputs are always going to be cost savings and we need to deal with these problems to society and keep them out of sight, you're probably going to create a fair degree of human suffering because it doesn't center the individual and the individual's needs. I think that's where we see the degree of human suffering that we do. Emmett, who was a patient at Northern State in the 50s, died by suicide in the 70s.

Merlin, his daughter, says by that time Emmett was bitter about how the psychiatric system had treated him, and she inherited those feelings. But Merlin says discovering Emmett's letter about Northern State from the 50s showed her a different side of her father, a side with more nuanced feelings about his time in that hospital. The way that I respond to his history is that there's this underlying layer of just rage that

fury and rage that what was supposed to be help for him was either useless or cruel. But at the same time, I can sort of rise above the rage and look at the different components, and there's parts that were terrible and parts that weren't terrible. And I think that he's doing the same thing. As for Carrie, who is searching for her great-grandmother Lillian...

One day, Sidney went with her to the state archives. Sidney's reporting had prompted the state to open a new trove of patient records that had previously been locked away. Families now had a chance to find their lost relatives in the decades-old paperwork. Carrie just wanted to find some acknowledgement of Lillian's life at Northern State. We're going to look at it like...

A book. And so we're just going to go page by page, and we're going to turn it like that, okay? Her hope was that she would find her great-grandmother. But of course, we had done a lot of managing expectations on the phone and in the car. She just kept repeating, we'll probably find nothing. I know I probably won't find anything. And I really was not expecting to find anything because I had sorted through these scraps before, and I didn't find any trace of Lillian in the scraps. If you need any help...

We're happy to help you. Oh, I'm sorry. I know it's not good. It's good. It's just a lot. Yeah. Yeah. She's in there. She's in there somewhere. I just gotta find her. An archivist flips open a registration book and turns the pages as Carrie looks on. All right. So we were looking for January 25. Let's go back. That was when she was admitted. Okay. All right. So here's January 25. January 1st. Let me just make sure. There she is. Oh.

She finds almost instantly Lillian's name on one of the population movement reports. And in one handwritten line, it shows her whole history at Northern State. It shows when she was admitted, what she was admitted for, when she was paroled, and when she died. Lillian Hansen from Skagit County. Female. She was 24 years old. Married.

Her occupation was housekeeping. She was from North Dakota and she was received January 13th and committed January 13th of 1925. Wow.

Looking at this, Carrie is able to picture her great-grandmother in front of someone who was maybe writing this at a certain point. And looking at that one line, she also realizes something that she hadn't realized before. It's that the date of Lillian's parole, meaning the days that she was allowed out of the hospital and back, overlap with her grandfather's birth.

Looking at that line, she discovers that her great-grandmother and her grandfather had five days together as a mother and a newborn baby before Lillian had to go back to the hospital. And that realization immediately overwhelmed Carrie and made her break down in tears.

Part of why Carrie cares so much about this is because it's not just this piece of distant history. Someone doesn't vanish from a family without a legacy of pain left behind. And her grandfather carried that pain his whole life, and that was passed down to her generation. So she's really dealing with an unhealed part of her. So she was real.

Coming up on Lost Patients, Northern State shuts down and a new era of psychiatric care is born. Lost Patients is a production of KUOW Public Radio and The Seattle Times in partnership with the NPR Network. You can support Lost Patients by investing in the local newsrooms and the specialized beats that make this sort of storytelling possible.

please consider joining and subscribing at KUOW.org and SeattleTimes.com. This episode was reported, written, and produced by Sydney Brownstone, Esme Jimenez, and me, Will James. Our editor is Liz Jones. Additional editing by Diana Samuels, Jonathan Martin, Brendan Sweeney, and Marshall Eisen. Project development by Laura Grenius, who also edited Sydney's reporting on Northern State Hospital.

Thank you to Seattle Times videographer Lauren Frone for sharing the tape she gathered, and to Seattle Times photographer Karen Ducey, who illustrated Northern State in the Seattle Times. Our music is by B.C. Campbell, mixing and sound design by Jason Burrows. Logo and branding by Alicia Villa and Michaela Giannotti-Boyle. Thank you to Carrie Davidson, Joanne McInnis, and Merlyn Rainwater for sharing your stories and your expertise.

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