by Jay Neugeboren
Asylum: Inside the Closed World of State Mental Hospitals
By Jay Neugeboren; Photographs by Christopher Payne with an essay by Oliver Sacks
(The MIT Press, 209 pages, $39.95)
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A patient ward in Buffalo State Hospital, closed in 1974.

Before I began this project in the summer of 2002,” writes Christopher Payne in his extraordinary and extraordinarily moving book of photographs, “I had never visited a state mental hospital.”

“A friend,” he explains, “who knew my interest in forgotten architecture and industrial archeology, told me about one on Long Island he thought might interest me. It was Pilgrim State, the largest facility of its kind in the world when it was built in the 1930s. I drove there and was immediately astounded by its size and dumbfounded by its desolation. . . . I wondered how a place so big, easily larger than any number of towns or major universities, could be so forsaken.”

Unlike Christopher Payne, I have been visiting state mental hospitals for nearly 50 years. My brother, Robert, now 66, first incarcerated in Creedmoor State Hospital in the mid-’60s, has been a resident of several of the institutions Payne photographed, and has been in and out of others most of his adult life. I have seen them at their best and their worst — when they were places where competence and kindness helped Robert to a better life than was predicted for him; when they were hellish warehouses of neglect and cruelty; and when they were, like the hundreds of thousands of people who inhabited them, forsaken.

Between 2002 and 2008, Payne ’90CC visited more than 70 hospitals in 30 states. The vividly exacting and brilliantly selective photographs he made for Asylum: Inside the Closed World of State Mental Hospitals chill by their very beauty and haunt by what is absent: We do not see a single picture of a living human being.

Oliver Sacks provides a splendidly informative and acutely sobering introductory essay to the book. “The first state hospitals,” he tells us, ”were often palatial buildings, with high ceilings, lofty windows, and spacious grounds, providing abundant light, space, and fresh air, along with exercise and a varied diet.”

“Most asylums,” writes Sacks, “were largely self-supporting and grew or raised most of their own food. Patients would work in the fields and dairies, work being considered a central form of therapy for them. . . . Community and companionship, too, were central — indeed vital — for patients who would otherwise be isolated in their obsessions or hallucinations.”

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