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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These hospitals, invariably built far from populated areas, also offered literal asylum by providing “control and protection for patients, both from their own (perhaps suicidal or homicidal) impulses and from the ridicule, isolation, aggression, or abuse so often visited upon them in the outside world.” By the end of the 19th century, writes Sacks, who is Columbia University Artist and professor of neurology and psychology, state mental facilities had “become bywords for squalor and negligence, and were often run by inept, corrupt, or sadistic bureaucrats.”

Payne grew up in Boston, and on childhood trips along Interstate 95, he saw Danvers State Hospital “looming in the distance, high on top of a hill. It looked like an ancient, far-away castle, with towers poking above the trees, forming a long string of peaks that hinted of its monumental size.”

Buffalo State Hospital, designed by H. H. Richardson.There is for Payne, as for Sacks, something utopian about these self-sufficient communities that ultimately, alas, devolved into dystopian dumping grounds. Through his luminous photographs, in both vibrant color and limpid black-and-white, Payne evokes the grandeur of the hospitals, and also their sadness, deterioration, and death. Judicious use of shadow and light, along with a shrewd mix of camera angles that, by turns, induce wonder, awe, claustrophobia, and vertigo, enable us to sense what can no longer be seen: what daily life might have been like in these places for patients, the majority of whom, once they arrived, never left.

Payne guides us from the majestic, decaying facades of asylums to their innards — from grounds, buildings, and farms to staircases, lobbies, and wards. The ward, he writes, was “the center of patient life . . . the space that best typifies the mental hospitals.

“The view down the corridor, with its rigid symmetry and procession of identical bedroom doorways, speaks to the monotony of institutional life. In all the hospitals, the wards were fundamentally the same, sharing a plan driven by the need for efficiency and organization. On their own, they are just hallways, but together they are symbols of a closed and isolated world.”

He takes us from rooms where people slept, to the coffinlike tubs in which they bathed; from the bakeries and kitchens where they worked, to the surgical suites where lobotomies and autopsies were performed. We see shoemaking and dressmaking shops, laundries, auditoriums, gymnasiums, baseball fields, beauty salons, TV studios, and bowling alleys, along with subterranean tunnels, heating ducts, and exhaust flues. We travel from asylums that seem, in colorful period postcards, luxurious vacation resorts, to still-life compositions of individual rooms, chairs, beds, and articles of clothing that startle by their stark, serene simplicity.

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