Mental Illness in the Family, Part 3

Unfortunately, the Library of Virginia reports that no records among the Southwest Virginia Mental Health Institute files can be found for my grandfather’s brother, Dan C. Troutman.[1] At least, SVMHI still has his admission and release records. He was first admitted 12 January 1929 and released 30 June 1930, reportedly “improved.” He was second admitted 6 July 1934 and died there almost fourteen years later on 2 July 1948, cause of death “Chronic Myocardial Degeneration.”[2] He was 65.

His illness never went into remission, his foster daughter Lois said. She lamented that the only treatment available for mental health patients at the time of Dan’s illness was phenobarbital, a sedative.[3] However, other treatments were being administered. One was hydrotherapy:

“Hydrotherapy was a popular method of treatment for mental illness at the beginning of the twentieth century, and was used at many institutions. . . . Water was thought to be an effective treatment because it could be heated or cooled to different temperatures, which, when applied to the skin, could produce various reactions throughout the rest of the body. One of the main benefits of hydrotherapy treatment was its ability to take effect quickly. Hydrotherapy could be accomplished with baths, packs, or sprays. . . . A patient could expect a continuous bath treatment to last from several hours to several days, or sometimes even over night. Continuous baths were the most effective when held in a quiet room with little light and audio stimulation, thus allowing the patient to relax and possibly even fall asleep. Bath temperatures typically ranged from 92°F to 97°F, so as not to cause injury to the patients. Packs consisted of sheets dipped in varying temperatures of water, which were then wrapped around the patient for several hours depending on the case. Sprays functioned like showers, and used either warm or cold water. Cold water was used to treat patients diagnosed with manic-depressive psychoses, [italics mine] and those showing signs of ‘[e]xcitement and increased motor activity.’ Application of cold water slowed down blood flow to the brain, decreasing mental and physical activity. The temperature for a cold pack ranged between 48°F and 70°F.”[4]

Was Dan treated with cold water packs? It seems likely since they were used at SVHMI, at the time he was there.

“In 1939, wet sheet packs were thought to be a more effective and humane treatment for the acutely disturbed than the previous practice of administering large quantities of narcotic drugs. Several attendants were trained in the application of the wet sheet pack and this treatment was used daily.”[5]

Unfortunately, SVMHI was understaffed in the late 1930s, and nurses lacked training in psychology and mental health treatments. Attendants were required to have two years of high school, to pass a physical exam, to be under age 40, and to undergo a probationary period of three months. Some were taught how to apply the wet pack treatments and a few were taught a Red Cross course in first aid. “They were encouraged to read certain text books on psychiatric nursing and some were given several weeks’ training on the insulin treatment ward. The attendant to patient ratio at the time [1939] was 1 to 15, which barely permitted more than custodial care.”[6] This gives me concern for Uncle Dan. Fortunately, the staff numbers increased over the years he lived there.

Another treatment commonly used at this time was metrazol convulsive therapy.[7] Patients were injected with metrazol, a powerful stimulant that caused convulsions and coma.[8] This treatment fell into disuse because severe convulsions too often resulted in fractured bones, and patients greatly feared the treatment[9]; it was discontinued at SVMHI in 1940.[10] Another treatment was insulin shock therapy.[11] This type of therapy involved large doses of insulin to keep patients in a coma. Electric shock was combined with both therapies, thus they were known as shock therapies.[12]

These controversial electroshock therapies reached a peak of popular use during WWII.[13]

These treatments seem the most likely candidates to have been applied to Dan Troutman. Fortunately, patients who were able were still being employed on the farm. I would like to think of Uncle Dan  outside and working in the fresh air more so than comatose from shock treatment. Perhaps, he even had opportunities to sing and play his guitar.

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[1] Karen Arnold, Health Information Technician, Southwestern Virginia Mental Health Institute, Marion, Virginia, to Zola Noble, 22 October 2015, letter, informs that records for Dan C. Troutman cannot be located among SVMHI records at the Library of Virginia; Dan Troutman foler, hanging files; privately held, [ADDRESS FOR PRIVATE USE] Anderson, Indiana.

[2] Arnold, Karen, Health Info. Tech., SVMHI, Marion, Va., to Zola Noble, letter, 23 Sept. 2015, includes info. from the Admission Register of SWVMHI; Dan Troutman folder, hanging files; privately held, [ADDRESS FOR PRIVATE USE] Anderson, Indiana.

[3] Lois Faris, Glade Spring, Virginia, to Zola Noble, 15 August 2008, letter, information on life as a foster daughter in the Dan C. Troutman home; Lois Faris file, Troutman family; privately held, [ADDRESS FOR PRIVATE USE] Anderson, Indiana. Also, Treatment of the Mentally Ill > 20th Century > Treatment Therapies, 7th bullet point (http://mentalillness.umwblogs.org/20th-century/treatment-therapies/ : accessed 30 October 2015).

[4] Restoring Perspective: Life and Treatment at the London Asylum > Medical Treatments > Hydrotherapy (http://www.lib.uwo.ca/archives/virtualexhibits/londonasylum/

hydrotherapy.html : accessed 29 October 2015).

[5] A Brief History of Southwestern Virginia Mental Health Institute, compiled by Phyllis Miller, (Virginia Department of Behavioral Health and Developmental Services, Richmond, Virginia, 2012.), p. 15; (http://www.swvmhi.dbhds.virginia.gov/swvmhi/about-us/brief-history-of-swvmhi.pdf : accessed 29 October 2015).

[6] Ibid.

[7] Ibid.

[8]  “What is Metrazol Shock Treatment?” Psychology Dictionary (http://psychologydictionary.org/metrazol-shock-treatment/ : accessed 29 October 2015). 
[9] Leopold N. Judah and Oddist D. Murphree, “Metrazol Convulsive Therapy Modified by Succinylcholine,” The Journal of Mental and Nervous Disease, Aug. 1959, Vol. 129, Issue 2, p. 198 (http://journals.lww.com/jonmd/Citation/1959/08000/Metrazol_Convulsive_Therapy_Modified_By.11.aspx : accessed 29 October 2015).

[10] A Brief History of Southwestern Virginia Mental Health Institute, compiled by Phyllis Miller, (Virginia Department of Behavioral Health and Developmental Services, Richmond, Virginia, 2012.), p. 16.

[11] Ibid., p. 15.

[12] “Insulin Shock Therapy,” Wikipedia (https://en.wikipedia.org/wiki/

Insulin_shock_therapy : accessed 29 October 2015).
[13] Treatment of the Mentally Ill > 20th Century > Treatment Therapies, 7th bullet point (http://mentalillness.umwblogs.org/20th-century/treatment-therapies/ : accessed 30 October 2015).

My Quilt Making Great-Grandmother

While I wait for records of my grand-uncle Dan Troutman to arrive from the Southwestern Virginia Mental Health Institute, I'll write a few lines about his mother America Pratt Troutman.

The two most prominent traits of hers that I heard growing up were her hot temper and her pipe-smoking. But she was more that that. She was the wife of a Confederate veteran who may have suffered throughout his life from the trauma of battle, of seeing his brother shot and killed, of a wound that took months to heal, of six months imprisonment in an over-crowded, hell-hole of a Yankee prison. She was a mother of ten children, five of whom died before she did. She was a caregiver of sick neighbors. She sat by their bedsides, washed and fed them, nursed them back to health or watched them take their last breath.[1]  One woman she cared for had her light her pipe; thus America developed a taste for tobacco and the habit of pipe smoking, she said.

Merky, as she was called, lived her last decade after her husband died mostly in Smyth County Virginia where she had lived all her life, but she spent a year in Nebraska with her son Clint's family. The story goes that Clint went to Virginia on a train and brought her back with him. She was quiet, the children recalled, often sitting in a chair reading her Bible and smoking her pipe when they came home from school. The year must have been about 1925 or '26. My dad remembered that he and his siblings were a little embarrassed about their grandmother's pipe-smoking. Once when they went to town, Merky's son Clint would not let her take the pipe with her. Then when Clint was smoking his cigarette, his mother asked for a drag. "It tastes good," she said.

America Troutman in Nebraska with three of her grandchildren: James, Virginia, and Neville, children of Clint Troutman. c. 1926. Photo from the Troutman family scrapbook in the possession of a cousin in Nebraska.

After her trip to Nebraska, she lived at Glade Spring with her son Dan and his family.  When she died, 14 January 1929,[2] she left a will naming Dan as her sole heir “for his kind care and attention to me.” She said she had already “given the others all I can give."[3]

Merky and a neighbor child at the Glade Spring home of Dan and Carrie Troutman, c. 1928.

But there's more to this feisty, pipe-smoking great-grandmother. She also made fabulous quilts. To my good fortune, I have one, the only one in existence, as far as I know. It’s a crazy quilt.

I received the quilt via my father’s cousin, Lois Faris, the foster daughter of my grandfather’s brother, Dan Troutman. Growing up, Lois was known as Lois Troutman. When she became an adult, she reconnected with her birth family and began using her birth name, Bethel. Then she married Gale L. Faris.

Though she dearly loved the Troutman family who raised her, she recognized that the blood ties were not there. That’s one reason she gave the quilt to me. The other reason was my interest in quilt making. At the time she brought it to me, about 1980, I owned a quilt shop in Chilhowie, Virginia, called The Quilt Corner. I made quilts and gave lessons on quilt-making and other types of needlework, a life-long passion all mine. One day, Lois walked into my shop carrying a folded quilt. Unfolding it on my worktable, she said, “This was made by your great-grandmother, and I want you to have it.” I'm sure I gasped! Based on my work in the shop, she thought I would appreciate it. What an understatement! I felt stunned, thrilled, awed, and humbled—all at the same time.

As I looked at this quilt, my great-grandmother’s creative nature spoke to me. Using wool and other fabrics, probably cut from suits and dresses, some dark and some bright, the maker’s practical side prevailed, but it was also a quilt of impeccable detail and artful whimsy. Perhaps, the contrast of dark and bright fabrics also revealed her moods. Perhaps, the irregular shapes echoed the mountains and valleys of her home.

Close-up sections of America Troutman's crazy quilt, c. 1900.

Many of the pieces were torn or threadbare, but it was the stitches that caught my breath. Intricate webbing connected each piece with threads in subtle colors of the sand in a mountain stream, the pink of a baby’s skin and the blue of a heron. Chain stitches formed circles interwoven like the Olympic games symbol, four on one patch and five on another. A row of six linked circles joined a triangle of brick-red wool with a tiny navy stripe to a tan and brown striped shape; some stripes in the fabrics were set at right angles to each other. Two chain stitch hearts intertwined on a navy background; a chain stitch formed the base for a wreath of daisy-like flowers on red; chain stitches formed the stem of a figure that looked like a lollypop. There were chevron stitches that looked like a split rail fence, fishbone stitches arranged like a row of tiny pine trees; feather stitches and fly stitches; blanket stitches that flipped direction every fifth stitch with star stitches inserted in the spaces; herringbone stitches and flat stitches. More star stitches were splashed here and there, one in the center of a patch. Some stitches, I could not find in my catalog of embroidery stitches. 

America Pratt Troutman's great-great-great-granddaughter studies the crazy quilt, 2013.

The quilt reminds me that our personalities are many faceted. Spunky America refuses to be labeled one way or another without all things considered.

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[1] Faris, Lois, Glade Spring, Virginia. Interview by Zola Troutman Noble. Notes. Privately held by Z. T. Noble, [ADDRESS FOR PRIVATE USE] Anderson, Indiana. 29 April 2010.
[2] Virginia, Death Records, 1912-2014, database Ancestry.cm (http://ancestry.com : accessed 20 Oct. 2015), America Ann Troutman, 1929.
[3]  Washington County, Virginia, Wills and Inventories, Book 33, p. 458, America Troutman; County Clerk’s office, Abingdon.

Mental Illness in the Family, Part 2

When my paternal grandfather’s brother Dan Troutman’s symptoms of mental illness started, I do not know. I thought it started after his mother died, as stated in the last posting on this subject, but I’ve learned that it was earlier. He was first hospitalized on 12 January 1929 just two days before his mother died. A year and a half later on 30 June 1930, his condition had improved enough that he was released.[1]

Located about thirty miles from Dan’s Glade Spring home, the place of his confinement was a long established and reputable treatment facility for the mentally ill, Southwestern State Hospital, now called Southwestern Virginia Mental Health Institute, in Marion, Virginia. He was diagnosed with manic-depressive psychoses, now called bipolar disorder; his symptoms included “severe and recurrent depression or mania with abrupt or gradual onsets and recoveries . . . . [recurring] cyclically.” Psychiatrists said it was inherited.[2]

Early 20th century postcard photo of Southwestern State Hospital.

Did Dan’s mother also suffer from bipolar disorder? Her foster granddaughter Lois thinks so. The family stories about my paternal great-grandmother, America Ann Pratt Troutman, described her as a high-strung woman with a volatile temper. Her son Clint told stories about her tirades, told of hearing his father say during his wife’s fits of anger, “If only I’d never crossed those mountains.” Lois also witnessed such behavior from her grandmother; America closed herself in her room for periods up to a week at a time, Lois said.[3] America’s symptoms must not have been as severe as Dan’s, however; she was never hospitalized.

Opening in Marion in 1887, the Southwest Virginia Lunatic Asylum, as it was then called, was considered state of the art: modern, convenient, and economical. The central building contained six patient wards (three for men and three for women) a kitchen, a bakery, two dining rooms (separate for men and women), a laundry, a sewing room, an elevator, and rooms for patients and attendants, and it was fully wired with electricity.[4] 

From its inception, the hospital included a complete working farm where many of the patients planted, tended, and harvested cash crops; in addition, they tended pigs, horses, cattle, and chickens. The grounds also included a shoe shop, broom and mattress shop, and upholstery shop. Patients well enough and willing were employed in all of these endeavors. The hospital was a self-sustaining “community within a community.”[5] The aim was “to keep the patients interested and the work pleasant.”[6] Plans for additional wings to house more patients soon materialized. In 1902 the name of the hospital was changed to Southwestern State Hospital.[7] 

The description of the place sounds idyllic. Dan would likely have enjoyed the farm work when he was able.

Henderson Building on SWVMHI campus, in recent years. Photo by Skye Marthaler, used by permission.

From 1887 when the facility opened to 1929 when Dan was first admitted, many changes occurred to the physical appearance of the campus. Outdated buildings were torn down and new and improved buildings were added. More acreage was purchased which increased the capacity for farming. World War I brought a rise in cost of goods and a shortage of personnel. If not for the farm and gardens, it would have been impossible to feed everyone.[8]

Many changes occurred in the treatment of mental illness during those years, as well. I’ll save that for next time.

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[1] Arnold, Karen, Health Information Technician, Marion, Virginia, to Zola Noble, letter, 25 September 2015, includes information from the Admission Register of SWVMHI; Dan Troutman folder, hanging files; privately held, [ADDRESS FOR PRIVATE USE] Anderson, Indiana.

[2] Manic-depressive psychoses, “Glossary,” Restoring Perspective: Life and Treatment at the London Asylum (http://www.lib.uwo.ca/archives/virtualexhibits/londonasylum/

glossary.html#manic : accessed 30 September 2015).

[3] Faris, Lois, Glade Spring, Virginia. Interview by Zola Troutman Noble. Notes. Privately held by Z. T. Noble, [ADDRESS FOR PRIVATE USE] Anderson, Indiana. 29 April 2010. Lois was a foster daughter of Dan and Carrie Troutman. She lived with them from age 18 months until she left for college.

[4] A Brief History of Southwestern Virginia Mental Health Institute, compiled by Phyllis Miller, (Virginia Department of Behavioral Health and Developmental Services, Richmond, Virginia, 2012.), p. 4.

[5] Ibid., p. 5.

[6] Ibid., p. 6.

[7] Ibid., p. 5.

[8] Ibid., p. 10.

© 2015, Z. T. Noble