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The Catastrophe of American Health Care

(PORTSIDE) ABBY CARTUS, February 23, 2023

Our current system defines health as the ability to work. Those who can’t are abandoned and exploited. If you’re too sick to work, you will be forced into poverty twice over: First by the loss of wages, and second, if lucky, by SSDI, or poverty.

never went to Dixmont, though lots of my high school classmates and friends did. My parents mildly discouraged me from venturing up into the thickly wooded hills where it sat, not because kids went there to drink and smoke and scare each other (which they did) but because the dilapidated buildings were full of friable asbestos and the underground tunnels were probably even more structurally unsound than the buildings. The property, at the time I was a teenager, had been essentially abandoned for more than a decade.

Dixmont was named after Dorothea Dix, the nurse and reformer whose lobbying efforts were instrumental in creating the asylum system in the United States. The asylum movement, originating in the 1840s, aimed to improve the treatment of people with mental illnesses, who were typically subject to a litany of esoteric forms of abuse and neglect including, but not limited to, exorcism, bloodletting, and warehousing in jails. Dix, who worked in a jail as an English teacher, was shocked by the conditions that psychiatric patients were subjected to and made it her life’s work to advocate for more humane treatment. She spent decades campaigning for state governments to open asylums, and in this she was successful. Dixmont State Hospital in Kilbuck Township, Pennsylvania—roughly 12 miles up the Ohio River from downtown Pittsburgh—was one of the fruits of her labors. At its peak, the hospital held more than 1,000 patients in therapeutic incarceration on its (originally) state-of-the-art campus including several buildings, manicured grounds, and even its own cemetery.

The reform movements that created the asylum system produced a myriad of new problems, cruelties, and abuses in an attempt to address the old ones. Dixmont, like other institutions around the country, came to embrace the disquieting practices of mid-century psychiatry, with the extensive use of restraints (including, when it became available, the use of the antipsychotic drug Thorazine as a “chemical” restraint), hydrotherapy (worse than it sounds), and electroshock. By the 1970s, Dixmont was in financial trouble, and in 1984 it was finally closed for good. The buildings were demolished years later, and all that remains today is the overgrown Dixmont cemetery, where patients were buried after they died in the hospital.

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