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By a power not doors for a

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statement, A satisfaction by a quiet. All

2:01

right, welcome back everybody.

2:06

Very very very looking

2:09

forward to this talk today. It's one

2:11

of those tough ones. It's

2:15

like I call it tough medicine talks, but

2:17

it's really fascinating. And

2:20

I heard about this book a while ago and

2:22

then I was reminded recently about it. I

2:27

love history, but finding about your own history

2:29

in surprising ways is

2:32

also very important. And this book kind

2:34

of does that in very stark ways

2:36

too. The book is called Madness, Race

2:38

and Insanity in a Jim Crow Asylum.

2:40

And I'm very happy to have very

2:43

Emmy and Peabody Award winning NBC news

2:45

reporter, Antonia Hilton, the author of the

2:47

book. Welcome to Black on the Air,

2:49

Antonia. Thank you for having me. It's

2:52

such a pleasure to have you. And

2:54

this is such a tough book,

2:57

an important book it feels like. You

2:59

know, this is one of those, man,

3:01

you know, I'm fascinated by how many

3:04

cracks there are out there, holes that we just

3:06

don't know about or that have been forgotten. They've

3:08

just things that have fallen through the cracks, I

3:11

should say, you know, I was

3:13

looking at a special when

3:15

Ina B. Wells the other day and even

3:17

in her lifetime, she had fallen through the

3:20

cracks, which is why she started writing her

3:22

autobiography. She's like, people have already forgotten

3:24

me. And it was like 20 years

3:26

after the fact, like Jesus Christ, things

3:29

fall through so fast. What

3:31

led you to this particular story in

3:33

this book? You know, I think there

3:35

are sort of two origin stories for

3:38

me. So the most obvious one is

3:41

I was just a teenager in college, I was

3:43

a freshman. And I

3:45

was trying out different forces, trying to figure out what I

3:47

wanted to do with my life. And I

3:49

stumbled into a class on the history of psychiatry.

3:52

And I think if you would ask me at

3:54

that time, it's just a 17, 18 year old, I

3:56

would have told you stumbled. I

3:59

would have called it a mistake. But now that

4:01

I'm a bit older and I've done this work for

4:03

longer, I can kind of

4:05

see the arc of my life and my

4:07

different influences. I then

4:09

realized that I think coming from a family that

4:12

refused to talk about mental health, refused

4:15

to acknowledge psychiatry, refused to

4:17

call therapists when things happen. I

4:19

think the kind of parents and

4:21

grandparents who would say things like, go to your room and

4:23

pray about it. Exactly. Yeah. That's

4:27

totally... That's why you need more Jesus in

4:29

you because you got them thoughts. Exactly. And

4:32

you solve your problems on Sundays and I guess you

4:34

just suffer the other six days a week.

4:37

The rest of the week, exactly. And

4:40

so I think... I don't think I could

4:42

have articulated it at that time. But now

4:44

I think that I became a journalist and

4:46

I became the kind of question

4:48

asker I am because it was so hard

4:50

to have those conversations and I felt so

4:53

shut out of a lot of

4:55

the adult life in my family. Me and

4:57

my six siblings, we come from a very big family.

5:00

We could tell there were secrets. We

5:02

could tell there were family members who

5:04

were sent to places to get help

5:07

or who were struggling with alcoholism or

5:09

anxiety, right? But you couldn't

5:11

get people to acknowledge it. And I think in

5:13

a weird way, they thought that by just pretending

5:15

things weren't there, that they could

5:18

protect us from ever experiencing those things. But

5:20

it was actually the opposite. The

5:22

more you sense there's something there and that

5:24

you're not getting honest answers, I think the

5:27

more anxiety you feel. So I went

5:29

looking for answers. And so I stumbled into

5:32

this work. And

5:34

the weird thing about studying the history of

5:36

psychiatry in this country is that it's almost

5:38

entirely taught to you from the perspective of

5:41

white people, white doctors, white patients. And

5:43

so if you come from a family

5:45

like mine, know immediately something's wrong with that because

5:47

you're like, okay, I know some people in my

5:49

family have experiences, but I can't find anyone like

5:52

us in the books. So

5:54

I just went looking for it. Yeah. And

5:56

it's like, you know, something sound racist,

5:59

but it's really cultural, like there is

6:01

a difference, especially in this

6:03

time period between white problems and black problems.

6:06

There just was a difference, you know, it's

6:08

not a racist statement

6:11

so much as it's a cultural

6:13

thing. And especially when you go

6:15

into the history of how Crownsville,

6:17

Crownsville is the name of this

6:19

asylum that you talk about,

6:21

tell us about Crownsville and how it got

6:23

started. What was it

6:26

like back then? Like what was the,

6:28

well these are a lot of questions I've learned

6:30

at you, but let's start with the place first

6:32

and also if you were black

6:35

and had mental problems, what happened to

6:37

you? That question alone is

6:39

a big question. Yeah, I know. So take

6:41

it in any order. Let's take that last

6:43

one first because let's talk about, we're about

6:46

1909 when it started,

6:48

the construction on this or in 1910? They

6:50

come up with the idea around 1909 and

6:52

the construction begins in 1911. Okay,

6:56

that's its own little story too. I want

6:58

to get to that. But let's talk about

7:00

the state of black mental problems

7:02

or however we want to talk about it

7:05

and what it

7:07

was like in the world there and

7:09

how it was dealt with. Well, when

7:11

you look back in newspapers, medical journals,

7:13

letters from politicians and important people at

7:15

that time, what you find is a

7:18

lot of white people complaining about black

7:20

people suffering. And

7:23

some of it came from a place of sympathy, from

7:25

noticing that a lot of them were poor,

7:28

that a lot of them seemed to be

7:30

emotionally unwell, and that

7:32

they were worried about these things. For

7:34

many others, it came from a place of annoyance, kind

7:36

of like, why can't they seem

7:39

to get with the program sort of thing?

7:41

And this is all in the years after

7:43

emancipation. You know, at this time in the

7:45

early 1900s, you're kind

7:47

of looking at the first generation of

7:49

people completely removed from slavery, or

7:53

there are elders around who still

7:55

were enslaved themselves. And so I

7:57

think being black, you kind of when I was looking at these I'm

8:00

like, wait, what do you mean? Why are you so confused

8:02

about why black people are suffering? I

8:04

mean, they barely escaped the system. They

8:07

haven't gotten a whole lot of support. And

8:10

so obviously, there's still the trauma,

8:12

both physically and physical and mental

8:14

trauma from that experience. And you

8:16

would think there'd be more acknowledgement

8:19

of that in medical and social

8:21

records of the time. But

8:23

a lot of it is white people actually being stumped about this.

8:25

And one of the prevailing theories they come

8:28

up with is that, oh, black

8:30

people's minds are kind of unraveling

8:32

because they no longer have masters

8:34

to take care of them. The good

8:36

old days are kind of gone. And

8:39

this is an attitude that's not

8:41

held by just a couple

8:43

random people in different corners of the country.

8:46

It's a pervasive attitude. It's

8:48

a published and debated attitude. It's

8:51

something that informed the beliefs and

8:53

attitudes of doctors who

8:55

founded modern psychiatry in this

8:57

country. Names are

8:59

on buildings and roads, not just in

9:02

Maryland, where my book takes place, but

9:04

all over the country. I mean, people who created things

9:06

like the American Psychological Association.

9:09

So what they believed and how

9:11

they felt toward black people informed

9:14

everything about the development of hospitals,

9:16

about the way they doled out

9:18

health care. And then the

9:20

way they interacted with black patients once they got

9:22

there. So in this time of year black

9:25

and you realize you're struggling, you try to go

9:27

to a place like this, you really

9:29

met with one of two things. Either

9:32

you're kind of shit out of

9:34

luck, frankly, and you are

9:36

told there is no health care, your family

9:38

can't afford it, and there is no

9:40

one to help you get real treatment at

9:42

that time. Or you're brought

9:44

to a segregated asylum or a

9:47

segregated ward in an asylum. So it's kind

9:49

of one or the other. And

9:52

you were treated by people who

9:54

were often very openly, very

9:57

open about the fact that they saw you

9:59

as less. than human. Which was the

10:01

normal way to see blacks. It wasn't

10:03

like that was abnormal. Not

10:05

abnormal at all. In fact, from

10:08

what I found in the records, I spent the

10:11

last 10 years gathering oral history

10:13

in the community because there are

10:15

elders who were still living in Maryland

10:17

in their late 90s who were

10:19

present still for the early period

10:22

of the hospitals operations. And

10:24

then going through decades of

10:27

letters, records, hospital reports,

10:30

data, patient files. And

10:33

what you find is that in those early years, the

10:35

majority of the people on the staff, I mean, all

10:37

white staff in a black patient population, the

10:40

majority of the people who came to work there openly

10:42

disliked, didn't want to listen to, and

10:44

even were embarrassed to be working with

10:46

the patients that they had. And

10:49

so for me, that kind of

10:51

immediately answered some questions when I got back

10:54

to my own personal experience of having

10:56

grandparents. I mean, my mom was born

10:58

in Baltimore actually. I

11:02

think about her mother who

11:04

was so anti psychiatry, so

11:06

again, therapy, and how

11:08

she grew up down the road from this institution. And

11:11

things kind of start falling into place. They start

11:13

making sense when you realize, oh,

11:15

they might hate this because it never

11:18

was for them in the first place. And

11:20

maybe they're not so irrational after all. No,

11:22

no. And I'm, you know, I think it's

11:24

important for people to know, like when we

11:26

talk about institutional racism, what that means, a

11:28

lot of people just think it means government

11:31

policies, but a lot

11:33

of it is, it's so hard to get

11:35

in a time machine and go back to how it

11:37

was back then. But there

11:40

was just a worldview about

11:42

the subhuman nature

11:44

of blacks, you know,

11:46

at the time that they just weren't the same

11:48

as white people, you know, and it was so

11:50

good. And this term, I'll

11:53

try to pronounce it, Drapitomania, is that

11:55

the term? Yeah. So this

11:57

is a, so we're not talking about

11:59

redneck. sheriffs in Alabama, you guys, we're talking about

12:01

a philosopher, psychiatrist,

12:04

you know, psychologists, you know,

12:06

well-respected people in their fields

12:08

coming up with clinical terms,

12:11

not slang, but clinical terms that

12:13

get into books that people

12:15

are taught about these things. So I want

12:17

to just point out that distinction. And

12:20

I had never even heard of this term before.

12:23

And one of the definitions is

12:25

the irrational and unnatural desire of

12:27

a slave seeking freedom. That's

12:30

crazy. And

12:32

you have to laugh to keep from

12:34

exploding. Yes. The thought that, you know, if

12:37

they had stayed slaves, they probably wouldn't

12:39

be going through all this. Exactly. And

12:41

what they're saying with that is, Emancipation

12:43

has been a mistake. We

12:46

are not responsible at

12:48

all for this community's continued

12:50

suffering for their pain.

12:52

And when you are treating them, you

12:55

know, this is someone who works with

12:57

patients, who's writing from the physical

12:59

perspective. So then bringing a patient

13:01

back to health, restoring

13:03

the natural order requires

13:05

what? Physical

13:08

labor, the antebellum social

13:10

order, subjugation, that's what

13:12

they're saying is healthy for black people.

13:15

Bringing it back to the natural order

13:17

that this definition implies, right? Exactly. That

13:20

that's the proper place. Now, Crownsville,

13:23

was this started as like

13:26

from a way to help

13:28

blacks? Was it from a point

13:31

of view where there was compassion?

13:33

Because I know a lot of things start

13:35

off like that, but then it becomes what

13:37

it is. What was the thinking behind Crownsville?

13:39

Like who started this? You know, compassion is

13:42

a tough word, because I think

13:44

you can get some of what they say

13:46

and see glimmers of compassion.

13:49

Contemporary compassion, I guess. Right.

13:51

And so you see some of the officials write

13:54

in these lunacy reports that Maryland

13:56

would publish, and they

13:58

describe poor Negro. being

14:01

treated like the beast of the field. And

14:05

you get the sense that they're not

14:07

comfortable with this, that they're outraged that

14:09

Black people who are mentally suffering are

14:11

being chained in the basements of buildings,

14:13

they're being left in stables with

14:17

farm animals, that

14:19

they're not able to get treatment because

14:21

they're barred from white facilities, and that

14:23

they must feel some sense of injustice

14:25

about this. But

14:28

then these same people, when they're coming up

14:30

with the solution, and they

14:32

then try to take action to serve

14:34

that patient population, these are the same

14:36

people who then make a very curious

14:39

decision about Crownville. So

14:41

they come up with this idea to build the place, they

14:44

specifically wanna federate it, separate Black

14:46

patients from white patients, but

14:49

they don't really wanna pay for it. So

14:51

they then come up with a

14:54

brilliant idea to force the patients to

14:56

build the hospital for themselves. This is

14:58

crazy. And doesn't that kind of

15:00

just tell you everything? I mean, it reminds

15:02

me of the thing you were just saying about Ida,

15:05

right? It's like, we can't even access

15:07

these things, can't have our stories told

15:09

without doing all the work for ourselves

15:11

up front. Right, right, right, right. We

15:13

can't get mental health care, we

15:16

can't get rest, we can't get access to the

15:18

facility, unless we're gonna do the

15:20

backbreaking work out in the cold of

15:23

literally building it brick by brick. So

15:25

that's what this colony

15:27

of patients is forced

15:29

to do. So they first start with 12 men

15:31

in the forest, and then every week they bring

15:33

in a bunch of new guys, some

15:35

of them are as young as 10 and 12 years

15:38

old, so children are present for this as well.

15:40

They are not carrying some

15:43

water and helping out in

15:45

an assistant role. They

15:48

are clearing forests, moving

15:50

railway tracks. They're

15:52

constructing a foundation, they are building

15:54

massive brick structures that stand to

15:56

this day in Maryland. If you

15:59

are... are ever

16:01

near Anne Arundel County, you can drive down

16:03

Crownsville Road and see them. They're right there

16:05

on the street. People who grow up in

16:07

this area grow up seeing these buildings, but

16:09

not knowing who built them. The

16:12

patients did. And that

16:14

is something no other group of patients

16:16

was ever forced to do. And their

16:18

pay was admittance into the facility. Right?

16:22

That was the thing. Yeah, and more

16:24

work. More work. So they finished constructing

16:26

the hospital and they're marched into this

16:28

institution that they just built. But

16:30

then they have to run a

16:33

massive plantation like farm. They

16:35

have to create baskets and

16:37

rugs to sell to offset the cost

16:39

of their own care. Not

16:41

to create their own income. And it's not a

16:43

jobs program where they're getting apprenticeships

16:45

and getting integrated back into the community.

16:48

I mean, they are literally creating goods

16:50

just to cover the cost of their

16:52

own food and survival in this institution.

16:55

It's working at a level and to an extent

16:57

that no other group of patients in Maryland are

17:00

being asked to do. And so there's this recreation

17:02

of those good old days. Everything

17:05

we just talked about, about doctors who

17:07

came up with terms like trapezoidomania and this

17:09

idea that what's healthy and good for black

17:12

people is just a whole lot of

17:14

work conveniently. So there wasn't any real

17:16

clinical treatment outside of

17:18

just labor therapy.

17:22

Well, there were these early practices that

17:24

we know now weren't doing a whole

17:26

lot. They used

17:29

things like hydrotherapy, which

17:31

could be great according to the record and could

17:33

be torture. So in some cases, it was like

17:35

getting put in a hot tub for a few

17:37

minutes for a patient and they would

17:40

like that. In other cases,

17:42

staff at Crownsville and other institutions

17:44

would submerge a patient in a

17:46

very hot or very, very ice

17:48

cold bath for about three days

17:50

at a time. At that

17:52

point, that's torture. They

17:55

would strap them into chairs. They

17:57

would leave them in cells, seclusion

17:59

cells. of a prison cell

18:02

for days at a time. And we didn't have much

18:04

in the way of medication. So

18:06

yeah, the majority of what

18:09

a patient's life and treatment

18:11

would have been like at the time

18:13

would have just been a whole lot

18:15

of work. And what was the determination

18:17

for admittance to that place? And who

18:20

determined that? Like who decided that

18:22

this person needed to go to

18:24

Crownsville? Well, kind of a network of

18:26

people. I mean, there's the admissions staff who

18:28

would work at the institution at that time

18:30

were all white. Some of the

18:32

people who worked on that team wouldn't have even had a college

18:34

degree. Some of them couldn't read or write. I

18:37

mean, even a high school degree actually, I should say.

18:41

And so, they are making

18:43

these decisions sort of just by sight and

18:45

by their own beliefs about the people who come to

18:47

them. Patients could

18:50

be sent by family members, people who could no longer take

18:52

care of them. In the case of a lot of

18:54

the children that came to Crownsville, it was that

18:56

their parents had passed away or could no longer

18:58

afford their care. And they felt they

19:00

had nowhere else to bring them, but to kind of

19:03

treat the asylum almost like an orphanage. And

19:05

then there were people rounded up by

19:08

police officers at night who

19:10

would get in trouble for petty thefts, like

19:13

stealing from a corner or a grocery

19:15

store. And they

19:17

would be brought to Crownsville even

19:20

if they didn't have any

19:22

kind of real diagnosis. And I could see that in

19:24

the record. So in those early years, it's

19:26

really hard to find information about patients'

19:29

actual diagnoses. It's

19:31

hard to find anything about their interior lives.

19:34

Rarely did doctors care to write notes about

19:37

what they were experiencing, what memories

19:39

they had, what was bothering or hurting

19:41

them. But there are lots of records

19:43

about how many rugs they produced each

19:45

month and how

19:48

many wares they were able to sell

19:50

or competition that they were able to

19:52

go to and the hospital was able

19:54

to get prizes or money from. Because

19:57

many of the patients were so talented and

19:59

basket. and in other skills, that

20:02

they were able to compete against other

20:04

institutions with the goods that Crown Soul

20:06

patients had made. And so

20:08

it's a lot easier to find out about

20:10

what they could produce than anything about who

20:12

they were. And it seemed like there were

20:15

just a real mix of

20:18

different types of people, especially

20:20

putting criminals or with

20:22

what people might consider criminally insane, which I

20:24

don't know how you make that distinction in

20:26

those days. But also that

20:29

would put, you know, that

20:31

could compromise just someone that isn't that,

20:33

you know, in a place like that.

20:36

You know, it sounds very dangerous to me.

20:39

Yeah. I mean, on the cover of

20:41

the book, you can see a boy,

20:43

a young boy right there out

20:45

on an adult ward. Right. And

20:47

that's what's happening there. People were all mixed

20:49

together. There were in some cases

20:52

hundreds of people sleeping in spaces designed

20:54

for say 60 or 80

20:56

people. And so they would be two

20:58

to a bed, head to foot, children sleeping with

21:00

grown men. And

21:04

this is not one of these things where, oh, back

21:06

then we didn't know that was wrong. There

21:09

were doctors writing at the time, people were writing

21:12

at the time, this isn't appropriate. We

21:14

need more funding. What are we going to do for

21:16

the children? How can we get them set

21:18

up a school for these kids? They're not learning anything. They

21:21

would write about this. And there

21:23

were family members and patients writing

21:26

to black-owned newspapers, begging them to

21:28

investigate, begging them to do something

21:30

about it. And so people knew

21:32

it was wrong even then, but the hospital couldn't

21:34

get the resources or the support to do anything

21:36

about it. Yeah. And some of

21:39

it's sad too, where you think about families that, you

21:41

know, if someone was like

21:43

that in their family, which, you know, we have

21:46

different diagnoses for today, you

21:48

know, they were maybe happy to have them go

21:51

off to a facility where they weren't responsible for

21:53

them, you know, one less mouth to feed and

21:55

that sort of thing. So you have those kinds

21:57

of stories too. Yeah. come

22:00

from a family like that. My great

22:02

grandfather was sent to an institution,

22:04

a segregated ward of an institution

22:06

in Michigan. It was because my family

22:08

didn't know what to do. They

22:10

didn't even know how to talk about it. And

22:13

to this day, my dad and

22:15

his brother and his cousins, they still

22:17

don't really know how to talk about

22:19

it. Especially because they

22:22

were so young as it was happening. And that

22:24

was the case for Americans of every

22:26

background at the time. There was so

22:28

much stigma. I mean, we still have stigma, but

22:30

at a level, I think some

22:32

of us wouldn't even be able to comprehend now

22:35

the amount of shame that could come down on

22:37

a family for admitting that someone was unwell in

22:39

that way. But for black people, there's sort of

22:41

this additional layer of shame because

22:44

you're kind of always in any

22:46

context, seemingly representing your entire race,

22:49

your failures and

22:52

your family's embarrassments take

22:54

on this immensity and

22:56

this weight that impacts,

22:59

of course, the patient and the person

23:01

who is suffering and experiencing that. So

23:03

kind of reconfigures and

23:05

reshapes your entire family as they

23:07

are suffering through

23:10

that experience with you. And my dad's

23:12

family was absolutely one of those.

23:14

That just was completely panicked. Didn't

23:16

know what else you do. And so

23:18

we have to send them to this place.

23:20

Yeah. Is touching on, yeah,

23:22

your personal story in here is very

23:25

moving too. Tell us about Maynard. Was that your

23:27

father's, what relation to him

23:29

was to your father? And that's my

23:31

dad's first cousin. That's his first cousin.

23:34

Yeah. And he's a little older than

23:36

him. My dad looked up to him for most

23:38

of his adolescence. Cause I was really moved

23:40

by how you talked about that. I mean, in the

23:42

book you said, when you swallow your pain, it never

23:44

does digest, you know, which are those very

23:47

prevalent, how it can manifest like in diabetes,

23:50

alcoholism, depression, things like that. And

23:52

it seems like mental illness in

23:54

blacks is part of a

23:56

result of this racial indigestion, I'll call

23:58

it. You know. It's

24:00

a good word for it. Yeah, racial indig-

24:02

Yeah, thank you. I thought that was good here.

24:06

But tell us about Maynard and

24:08

how your process of even finding

24:10

that out and going, you know,

24:13

kind of chipping away

24:15

at finding out that story is

24:17

interesting too. Yeah. Maynard

24:20

was my dad's big cousin. He

24:22

grew up in Mobile, Alabama. My dad

24:24

was growing up in Detroit and Maynard

24:26

would come to visit a lot. He

24:28

wanted to be a lawyer just like

24:31

my dad's dad. And so he

24:33

came several times, but one

24:35

summer that really stands out to my father

24:37

when he was just 11 years old, Maynard

24:39

came to live with them for several months

24:41

in Detroit and kind of followed my grandpa

24:43

everywhere. My grandpa was working

24:46

as a civil rights attorney and helping a lot of

24:48

families in the area. And Maynard

24:50

basically acted as his assistant, his clerk.

24:54

And my dad's memories of Maynard are that he would

24:56

get up in the morning and put on really cool

24:58

suits. He was so stylish and

25:00

cool that he listened to

25:02

the last poets, the forefathers

25:04

of hip hop that was

25:06

really always interested even with the

25:08

youngest members of the family in

25:11

debating everything about politics and civil rights.

25:13

He would talk about Richard Nixon in

25:15

front of my dad. He would

25:17

talk about, you

25:20

know, conflicts and riots in

25:22

Detroit. I mean, he was just open

25:24

to... He didn't think any

25:26

of that was off the table or that there was

25:28

a separation between the older cousins and

25:30

the adults of the family and the kids. He

25:32

thought kind of everybody needed that education. He

25:34

likes to play lacrosse and he likes to

25:36

joke that it's the best sport for black

25:38

people to play because we could get

25:41

the opportunity to whack white people in the head. And...

25:44

I had not thought about it that way. I was like, oh, I never tried lacrosse.

25:46

Maybe I could have. But, you know,

25:48

those are the things that stand out in

25:50

my dad's memory. It's

25:58

just really just this cuddly. be an

26:00

impression on him about what it meant to be

26:02

unapologetically black and to,

26:05

um, and to just be

26:07

insistent and proud about

26:09

who you are and your success in your future. Um,

26:12

and to not operate from a place

26:14

of shame or fear. And then as

26:17

Maynard gets older, it becomes clearer to

26:19

my dad, to Maynard's brother, Kendall, um,

26:21

and some other people in the family

26:23

that he's becoming more anxious, more morbid.

26:26

Um, he goes to the University

26:28

of Alabama not long after George Wallace had

26:30

put on his big show there to keep

26:33

black people from being able to enroll. And

26:36

my family started hearing all these rumors about

26:38

the KKK swarming and watching

26:40

the campus at the same time

26:43

Maynard is becoming really paranoid and

26:45

it's very hard to understand is

26:48

it mental illness is he and

26:50

hearing things. And those types of

26:52

moments, you never know if

26:54

a person is cracking or what's

26:56

really happening in there. And so

26:59

something, there's definitely a change in him at

27:01

this time, right? There's a change

27:03

at that time. But when I

27:05

talked to my dad and said, Hundal, who's this

27:07

Maynard's younger brother, who's still alive, Kendall

27:10

and my dad felt like, you know, when I,

27:12

when we think back to it, it's so hard

27:14

to parse it all apart because you're

27:16

just, so many black men

27:18

were paranoid at that time in the

27:20

six and seventies. So many of the

27:23

people were talking about the man, you

27:25

know, and we now know that at

27:28

the highest level of our country's government,

27:31

they were monitoring black people, black

27:33

leaders, black gatherings

27:35

and political thought.

27:38

And this idea that someone

27:40

was watching you was substantiated

27:42

in many ways. And

27:44

so it was hard from a distance while your cousin

27:47

is in college to figure out, you

27:49

know, what's fact in fiction, what's right

27:51

and wrong, what's sick and well. And

27:54

so it becomes very clear

27:56

as he eventually is diagnosed

27:59

with a schizophrenia and he

28:01

starts to suffer and

28:03

to hear and to

28:05

see hallucinations. And

28:07

my dad was still so young at the time,

28:10

so he didn't understand why it was so hard

28:12

for the family to get him healthcare. But

28:16

it all kind of comes full circle

28:20

one day when my dad gets a call and

28:22

his family gets a call in their home in Detroit.

28:25

And they find out that Maynard had

28:27

a mental health crisis, this sort of

28:30

episode publicly on the federal building

28:32

steps in Mobile. And

28:34

that within seconds of finding him, a

28:37

white police officer shot and killed him.

28:39

Nobody in the family was there to

28:42

witness his final moments to verify what

28:44

the officer claimed Maynard did that day,

28:46

which is that he claimed Maynard had

28:48

run at him with a gun. And

28:52

he died just a few hours later in

28:54

the hospital and his death

28:56

changed my whole family. My

29:01

dad immediately lost this mentor and best

29:03

friend, this

29:05

person who had tried to bring him

29:07

in and introduce him to new ways of looking

29:10

at the world and to loving

29:13

being black. And

29:16

that person was gone. My

29:19

grandparents, according to my father, really didn't know

29:21

how to handle it and talk about it.

29:24

And they had also just not

29:26

that long before lost my great grandfather,

29:28

who had also suffered mentally after being

29:30

harassed by the KKK in Georgia, which

29:32

is why my family ended up in

29:34

Detroit in the first place. So it

29:36

felt like just this one tragedy

29:39

after another piling up on them.

29:42

And then a year after Maynard passes

29:44

away, Maynard's father dies of what

29:46

people in my family described as a broken heart.

29:48

And so at that point, it just becomes impossible

29:51

to make sense of it all. And

29:54

so for a really long time, and certainly for

29:56

all of my childhood, Maynard

29:59

was... like this

30:01

ghost, this person that I

30:03

knew existed, but nobody knew

30:05

how to acknowledge or talk about. People

30:08

hid his family photos. So my

30:10

family has photos and artwork

30:13

all over the place, but you

30:15

couldn't find Maynard anywhere. There was

30:17

kind of shame about him, it sounds

30:20

like, right? Or just denial maybe or...

30:22

Denial might be a better word. I

30:24

think it's fear of even

30:26

just looking in his face and trying to

30:29

understand what had happened to him. I

30:31

think there was also shame, not just about

30:33

the shame of having a loved one with

30:35

mental illness, but also the shame of feeling

30:37

like you failed a loved one with mental

30:40

illness. And I think some of

30:42

that still lingers in my family. And

30:44

so Maynard becomes one of those stories

30:46

that I was talking about, those family stories

30:48

where me and my siblings

30:50

know something is there. We

30:53

know something existed. We see when

30:55

it comes up briefly that there's

30:57

pain on people's faces, but

31:00

we're never really invited into the world and we

31:02

know how Maynard dies, but we never get to

31:04

hear about how he lived. And that really

31:06

changed all of us. And so I

31:08

felt like I should talk about some of that in the book

31:11

because beyond

31:13

just introducing people to this history,

31:16

that while difficult

31:18

is also, I hope it

31:20

reminds people too that if

31:23

you come from a family where there's been this

31:25

kind of suffering or if you yourself are struggling

31:27

in this way, you are absolutely

31:30

not alone. You actually come from

31:32

a long history and generations of

31:35

people who tried to access the scare and

31:38

not always been able to. And

31:41

if you come from a family that's struggling to talk about

31:43

these things, perhaps seeing this history up

31:45

close will give you a little patience and

31:47

compassion because you can see just

31:51

how much it's not our fault. And

31:53

so I felt like if I share a little

31:56

bit of the personal story, maybe I can make

31:58

the reader feel more comfortable, more confident. and

32:00

talking about their own stories or going

32:02

to their own family members and saying,

32:04

let's finally talk about this. Because that's

32:06

what the research of this book is

32:09

for me. It made me push my

32:11

family to talk. That's amazing. You

32:13

know, when you talked about, when you took

32:15

that class, it almost feels like you

32:18

had this calling, you know, to tell

32:20

this story about your family as well

32:22

as this other stories, like this dual

32:24

calling almost, you know. Yeah, and I

32:26

didn't know it and I couldn't

32:28

have articulated it, but I

32:30

did feel very drawn to this work. Even

32:34

after graduating and starting to pursue my

32:36

career in journalism and traveling all

32:38

over the place and dealing with the demands of

32:40

daily news. And by the time I graduated from college,

32:42

you know, Trump was running for the

32:45

first time and everything just was

32:47

so upside down. And

32:49

so I think it could have been really easy for me to

32:51

have forgotten about my love of this, my

32:53

discovery of this hospital and kind

32:55

of just push it to the side. But

32:58

I just kept coming back to it

33:00

all the time. I kept building new

33:02

relationships with people in the community, in

33:05

particular, like this amazing group of black

33:07

families and healthcare heroes in Maryland who

33:09

come into this place partway to

33:11

this book and they really step up

33:13

and start to save patients' lives

33:15

and reform the institution. And

33:18

then I was just so drawn to them. I

33:20

think kind of shocked and surprised that no

33:23

one had told their story before. No one had given

33:25

them their flowers. And so I

33:27

just couldn't really, I couldn't let it go for

33:29

all the personal reasons, but also just

33:31

I think because of what the reporting

33:34

started to represent to me. Yeah, one of the

33:36

things, I actually wanted to read a little

33:38

bit of this because it's so powerful, if I may. I

33:44

don't do this all the time, but sometimes when it's this

33:46

powerful and I'll tell everybody what it is. So many

33:50

people think that Jim Crow

33:53

was mainly segregation,

33:57

that you couldn't eat in this

33:59

restaurant. if you're like, you couldn't

34:01

use this bathroom, you couldn't use this water faucet.

34:03

And certainly separation was a part

34:05

of it, but there is a different part of it

34:07

that is under talked about. And

34:10

it's about how blacks

34:12

were also terrorized, and

34:14

how terror was used against this,

34:16

which leads to

34:18

the talk about mental illness as a result

34:20

of this terrorization. But

34:22

lynching, which is, I think, an under talked

34:25

about thing in this country, because it's so

34:27

painful and so graphic and everything. I

34:29

mean, you talk about it in your

34:31

book and tell us some

34:33

of these stories, and I'm amazed at the research in

34:36

it. But I wanted to share this with people, because

34:38

I think people need to hear these things directly

34:41

sometimes. And I will warn

34:43

people, this is very graphic,

34:46

but it's very real, just so you get a sense. As

34:50

a black man, and this is about Matthew

34:52

Williams, who had a disability that we can

34:55

say these days, I'm not sure

34:57

where you would define him, but

34:59

I'll just say this part. As a black man

35:01

with a cognitive disability, Matthew Williams never

35:03

stood a chance. Williams arrived at Peninsula General

35:06

Hospital, semi-conscious and bleeding out from his wounds.

35:08

You tell the story of how this happened,

35:11

which we won't

35:13

go over now. But the hospital staff

35:15

quickly formed a judgment. Williams, already labeled

35:18

as strange, was restrained in a straitjacket

35:20

to keep from being violent. A

35:23

group entered the hospital, demanding that Williams be

35:25

turned over to them. The men

35:27

threw Williams covered in bandages and wearing a

35:29

straitjacket out of a hospital window and into

35:32

the crowd of 300 people waiting below. A

35:37

lot of people don't know how mob, it's

35:40

really happened, this is how it happened. As

35:42

men carried Williams to the courthouse, the

35:44

crowd swelled until a mob of some

35:46

thousand people surrounded Williams. He was pushed,

35:48

stabbed with an ice pick, and

35:51

dragged by a truck. County

35:53

Sheriff Phillips attempted to prevent the lynching, but

35:55

the mob pushed him to the side. At

35:57

8 p.m., the crowd fixed up a new

35:59

symphony. found a branch 20 feet above

36:01

the ground. They tied an unconscious

36:03

Williams by the neck and begin

36:05

to lift him up, then

36:08

drop him down over and

36:10

over again. The mob allowed Williams

36:12

to hang lifelessly for 20 minutes as

36:14

they mocked the victim and took parts of

36:17

his anatomy as souvenirs. After

36:19

Williams thumped to the ground one last time,

36:21

the crowd followed the body as

36:24

it was dragged behind a truck once

36:26

again. This time toward the

36:28

black section of Salisbury off Poplar Hill

36:30

Avenue. Finally, after about an hour of

36:33

further torture of his corpse, William

36:35

was tied to a lamppost, doused

36:38

in gasoline and oil, and

36:40

set on fire in front of a

36:43

store. So as the papers reported, all

36:45

the colored people could see him. According

36:47

to local black reporters at the Afro, black

36:50

residents fleeing in terror could smell Matthew Williams

36:52

burning flesh in the air. The

36:54

mob removed Williams' fingers and toes and

36:57

threw them on the porches of black

36:59

homes, shouting that they should make nigger

37:02

sandwiches. Whew,

37:05

now, that's what

37:07

it was like back then, everybody. That's what

37:09

it was like. This

37:13

type of reporting is a definition of bravery,

37:16

what you're doing here. And we're

37:19

both emotional, just hearing that. I

37:21

can see it in your face too, it's focused. These

37:24

are real people, it's real story. Of,

37:27

you know, there's so many different things that

37:29

are caused by these actions. My sister and

37:31

I had this conversation a couple of years

37:33

ago and she was

37:35

talking about how many of the problems,

37:38

especially like alcohol and schism and, you

37:41

know, broken families and some of these things

37:43

are a result of being terrorized for so

37:45

long too. Speak about why

37:48

it was important for you to include, that's

37:50

just one passage, but there's some others in

37:52

the book. Why is that important for

37:54

people to hear that? For a few reasons, I mean,

37:56

you sort of touched on this, but black

37:59

people were living. in a real

38:01

horror show at the time. And

38:04

this idea that they had fears of what

38:06

people might do to them, in

38:09

many ways, it was completely logical to

38:11

stay up at night wondering what might

38:14

happen to you. To think

38:16

twice before you walked through a certain

38:18

neighborhood, to be worried

38:20

that you can't make any kind of

38:22

mistake and to send any

38:24

family member of yours who seemed a little

38:26

outside of the box to a place like

38:28

Crownsville. Because for many of those families,

38:31

and I write about this, Matthew Williams, life

38:33

comes to an end in that particular part

38:35

of Maryland, because he's in such

38:37

a rural area so far from a place

38:39

like Crownsville, that when

38:41

you had children who were mentally different

38:43

or suffering at the time, if

38:47

they weren't going to end up at a place like Crownsville, they

38:49

were very likely going to make social

38:51

mistakes that led them to be treated

38:54

by a mob like that. The interpretation

38:57

of white people at the time for

38:59

black behavior or those types of things,

39:02

if you were an autistic child and

39:04

looked a white person in the eyes

39:06

or did some kind

39:09

of behavior, good luck. Or just spoke

39:11

to them in a store. Right, just spoke to

39:13

them in a store, right. Yeah. I write at

39:15

one point in the book about a patient who

39:17

ends up at Crownsville for decades and

39:19

discovered by one of the administrative

39:21

workers in the 60s when she gets there

39:24

on 1967,

39:26

68. And she discovers that there's a patient at Crownsville

39:29

who has been there for decades for

39:31

having committed the crime of cutting a white

39:33

person off in traffic. I'm

39:37

quiet because it's hard to find.

39:39

I have no words. Right. You

39:42

know, I wanted to, I

39:45

guess, deal with that history to

39:47

acknowledge the role that terrorism played in

39:49

all of this because it

39:51

absolutely has a connection to health

39:53

outcomes in the past and in

39:56

the present. This

39:58

area, the eastern shore. which is

40:00

where that lynching took place. This

40:03

is an area that is still one of the most black

40:05

parts of Maryland. Generations of

40:07

black families still have connections

40:10

there. Their grandparents saw

40:12

things like this. And

40:14

so this idea that

40:17

this period in our country is water

40:20

under the bridge is a whole

40:22

long time ago. We don't need to talk about it

40:24

in schools anymore. We can get through those books. Why

40:27

can't we just move on? Well, it's really hard

40:29

to move on. Right. Why

40:32

can't we just move on? Get past

40:34

it. Yeah, get over it. Well, it's

40:36

really hard to get over it when you

40:38

realize that it's not just Massey

40:40

Williams who lost his life, his

40:43

humanity that day. It's

40:45

an entire community that saw what happened

40:47

to him, that was spoken

40:49

to, treated to, subjected to what

40:51

that mob did. Then of course,

40:54

there's no justice after that. Nope. So

40:56

what that system

40:59

of terror did was

41:01

send a physical and a

41:03

violent message, of course, but

41:05

also a psychological message to black people.

41:08

We own you. We control you.

41:10

And no matter what we do to

41:12

you, your spirit, or your body, there

41:15

is not a damn thing you can do about

41:17

it. No one will be held accountable.

41:20

We'll do it on the courthouse lawn. We'll never

41:22

do it in your neighborhood. We'll do it on

41:24

your porch. There will be nothing you

41:26

can do about it. You

41:29

will need to wonder every day

41:31

if you might meet that same fate

41:34

and do your best as the

41:36

goalposts keep moving to survive.

41:40

And what's best for you? I

41:43

don't think you need to go to medical school to know.

41:45

Yeah. When you're told

41:47

you're worthless, James Baldwin talked about this,

41:50

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41:52

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41:54

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41:56

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41:59

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43:51

How did Crownville evolve over the years?

43:54

There was a point in time where

43:56

they got their first black professional in

43:58

there. What

44:01

was happening during that time? Yeah, this

44:03

is probably my favorite period of the

44:05

book. It's in the late 40s

44:07

into the 50s. And

44:10

the war just changed everything and the

44:12

hospital has been through the wringer. And

44:15

they lost resources at one point

44:18

during World War II. The

44:20

hospital had something like about a

44:22

dozen staff members working for about

44:24

thousand something patients. For

44:26

a week, they'd gone without having access to soap because

44:29

so many basic supplies had become unavailable.

44:32

And so really the hospital has been like hell

44:35

on earth. And the guys

44:37

who's been running the hospital for so

44:39

many years, this white doctor named Dr.

44:41

Robert Winterode, the guy who had created

44:43

this whole plantation structure and so loved

44:46

that power structure in the institution.

44:49

He starts to kind of fade

44:51

from view and plot his exit. And

44:55

a Jewish man who has just

44:57

narrowly escaped the Holocaust, escaped the

44:59

Nazis himself, he arrived. And

45:02

he takes over the institution from the

45:04

sky. And he pretty

45:06

quickly starts to see crownsville for exactly

45:08

what it is. And

45:11

he sees the broader system of segregation

45:13

and apartheid in this country for

45:15

what it is because he just survived

45:17

it. And so he

45:19

makes this pretty quick move to

45:22

integrate the hospital to find some

45:24

early Black employees to come in and to

45:26

start changing the culture. And the

45:28

first man to come is a man

45:30

named Vernon Sparks, who

45:33

is a psychologist who is

45:36

the first person, the first Black person

45:38

to get to step foot into the

45:40

all-white employee dining hall. And

45:43

he really has

45:45

to take on this kind of mystic

45:47

level of grace and patience. And

45:51

he comes into this place. And what's so

45:53

fascinating about Vernon and then a whole number

45:56

of people who fall Vernon, both as doctors

45:58

and then as some of the first aides. nurses.

46:00

Again, many of them are still alive and

46:02

I've had the honor of spending time with

46:04

them. You know, they've been

46:06

sent all these messages for years. You know,

46:08

black people aren't capable. You're not qualified.

46:11

You don't deserve these jobs. And

46:13

they come into Crownville and

46:15

their jaws drop, not just because

46:17

they see how the patients have been treated

46:19

and how poorly and how filthy this place

46:21

has been running. But they

46:24

also find that their colleagues, in

46:26

some cases, can't read and write. That

46:29

many of them have fabricated or lied about

46:31

their level of education. So many of them

46:33

are not actual nurses at all. Many of

46:35

them are addicted to mess and

46:38

are operating and working and walking

46:40

around this and driving around this

46:43

institution while visibly high, maybe

46:45

arguably themselves needing

46:48

inpatient treatment at

46:50

some sort of facility. And

46:53

so they are starting

46:55

to have trouble figuring out, well, who's

46:57

actually, who's sick? Who's well here? Who

46:59

are the sick ones? And there was

47:01

sexual abuse going on and those types

47:03

of things? Yeah. All of that.

47:06

And so this idea that the black people

47:08

had been unqualified and unwell. Right. And the

47:10

white people had had it all figured out,

47:13

becomes very quickly, immediately, it

47:15

becomes clear that that's all been a

47:17

lie. And so a power struggle

47:20

really ensues where there is these old

47:22

white employees who've been there for all the

47:25

good old days and the original structure who

47:27

kind of could do no wrong because

47:29

it was always their word versus the patient. And

47:32

then there's a new generation of black employees, many

47:34

of whom are just in their 20s. I

47:37

mean, these are really young people coming in

47:39

to the hospital, getting their very first job.

47:42

And they know these patients, not just

47:44

on some surface level diversity type stuff.

47:47

I mean, they went to church with them.

47:49

They rode a bus to school with them.

47:51

Or their own cousins. I mean, some of

47:54

them are literally related to patients. They come

47:56

in and they're like, okay, this

47:58

is my, you know. generations of

48:00

them having connections, not just a couple of

48:02

them, a whole lot of them. And

48:05

so they end up in this really

48:08

fascinating power struggle.

48:11

And they end up in this very morally

48:13

gray area where every day they're coming to

48:16

work, having to make these difficult choices about

48:18

serving the community that they love. Of

48:22

course, wanting to build the careers and feed

48:24

their own families and have a job and

48:26

have opportunities which were few and far between

48:29

at that time for so many black professionals.

48:32

But also knowing that they were working alongside

48:36

white people who they frankly despised

48:39

and who they knew didn't see them

48:41

as human. And

48:44

that wears on them too. So

48:46

the employees themselves are in many

48:48

ways emotionally suffering through this

48:50

experience of trying to take care of their

48:52

own communities, emotional suffering. And

48:57

so many of them end up working at this place for 40, 50

49:00

years dedicating their entire lives

49:03

to just doing what they can every day to get

49:06

one more patient out of there, to connect their

49:08

cousins to a clinic so they can go back

49:10

home to... In the case

49:12

of patients like the person I mentioned who's

49:14

brought for cutting someone off in traffic, just

49:16

get them out and back into the

49:19

lives that they deserve. Reclaim their life.

49:21

Yeah. Exactly. It's

49:24

not some medication or some

49:26

technology that arrives that assists them in doing

49:28

this. It's just the fact

49:30

that they love and care

49:32

about and see their own neighbors as

49:35

people deserving of good healthcare, that

49:37

they're able to make these changes.

49:40

And so there's this moment too where more and

49:42

more white people start leaving the institution because they

49:44

don't want to work with these black people. Yeah.

49:48

And so this weird thing happens where

49:50

crowds will actually start to look like

49:52

a community hospital, like all black doctors

49:54

and nurses, all black patients. Everybody

49:56

knows each other's mama and the church that they go to. their

50:00

lives, their social lives are intermixed. I mean,

50:02

I spoke to employees who were like, you

50:04

know, the way I knew I had done my job right was

50:07

that I would go to the bars that I liked to the

50:09

jazz clubs and I'd see my patients there because they got out.

50:11

That's hilarious. Wow. You

50:13

know, that's how they knew they were doing good.

50:15

And when you think about that and you look

50:17

at like our healthcare system now and you realize,

50:19

well, we don't really have anything like that. Right.

50:22

A stake in it like that. Yeah. Yeah.

50:25

If I wanted to get any kind of healthcare, put

50:27

mental healthcare to the side, just any I

50:30

did not know a hospital where I could be guaranteed

50:32

to be taken care of by entire black people.

50:35

Yeah. All of whom like know

50:38

my life and my context and

50:41

my culture, uh, who probably have my

50:43

mom or my grandma's phone number, you know?

50:45

Right. There is nowhere

50:47

we can get healthcare like that now.

50:49

Or at the least for somebody to

50:51

take your pain seriously, which why

50:53

is that such a big problem with

50:55

not just mental healthcare, but, um, and

50:58

especially with black women of their

51:01

pain being taken seriously. Well,

51:04

if you talk to black doctors and clinicians, they'll

51:06

tell you that it has a connection. So all

51:09

that stuff we were talking about about

51:11

the doctors writing their theories about black

51:13

people and design these medical schools

51:15

in these programs. When

51:17

we see surveys now that show that

51:19

there are medical students, the majority that

51:21

still will say that they think black

51:23

patients need less pain medication, or

51:26

you find that they treat black women

51:28

differently while they're pregnant or complaining of

51:31

certain symptoms, uh,

51:33

that this comes from the,

51:36

the, the founding of this

51:38

system and the early attitudes

51:41

of the people who created not just

51:43

the hospitals, but also the education system

51:45

and all of the structures around healthcare

51:47

in our country. They would say it's

51:49

not a coincidence and every era has

51:51

to build upon the era that came

51:54

before it. Right. And so that's why

51:56

we don't really get the privilege in this country of being able

51:58

to say that what happened a hundred years ago doesn't. matter

52:00

anymore. We don't need to talk about it anymore.

52:02

Because we actually cannot understand our

52:04

current context. We cannot solve

52:07

things like the maternal health crisis in this

52:09

country. We won't be able to figure

52:11

out why is it that we only have about 2% of

52:14

our psychiatrists are black? Why do black people feel so

52:16

excluded from this place? Why do they struggle to find

52:18

therapists? Why is it so hard? Well, you

52:21

can't actually answer that question without going backwards.

52:23

Take a look at what we did, the

52:25

choices we made, the system we built. And

52:30

if any of these people ever get serious about trying to do

52:32

better by us, they're going to have

52:34

to reckon with all that. And

52:36

that's not just my personal feeling. I mean,

52:38

black doctors and people who study the current

52:40

mental health care crisis who I

52:42

spent a lot of time talking to

52:45

one black psychiatrist named Dr. Tammy Benton,

52:47

who's a leader

52:50

in her field and works for the population of

52:52

black children in Philadelphia. And

52:54

they've been screaming from the rooftops for years

52:57

trying to get people to listen to what

52:59

they have to say about what's happening to kids

53:01

of color when they interact with the system. They

53:03

just can't get everyone to listen to them.

53:05

It's like when you hear those stories like

53:07

kids in school or how the black kids

53:10

are punished in

53:12

these outrageous ways. And it's

53:14

like a microcosm of some of the stories you

53:17

talked about that happened 120 years ago and that

53:19

kind of stuff. You see that happening today or

53:22

the kid who was stopped by the police

53:24

and he had the medical issues and they

53:26

gave him those drugs

53:28

or whatever and killed him. And he was

53:30

telling them he was a good kid and

53:33

he may have had some learning

53:36

disabilities or I don't know what you would

53:38

call it. He may have been on the

53:40

spectrum or something. But to me, that was

53:42

such a visceral example. You're talking about a

53:45

police plane, right? Yeah, yeah, I couldn't remember

53:47

his name. That story, I mean, my son

53:49

has Asperger's and when I

53:51

saw that story, oh God, my heart just leapt

53:53

out of my chest just thinking, the

53:56

kid's just expressing himself. He's

53:58

just being himself. You know

54:01

the way he was I was imagining him the

54:03

way he might have been walking down that street

54:05

He's a suspect to them, which is crazy and

54:08

he's just being a kid, you know Yeah,

54:13

exactly who's he a threat to exactly

54:15

yeah I tell the story at one point

54:17

in the in the we get deeper into the

54:19

book in the 80s And the

54:21

hospital really is this all-black place of

54:25

a six-year-old boy who gets brought

54:27

to Crownsville and Doctor

54:30

named dr. Brian Sims is on duty

54:32

at the time and he sees this cop car pull

54:35

up and a six-year-old boy

54:37

in a karate uniform dragged out

54:39

of the car by about five

54:41

six cops and Immediately,

54:43

he knew something was wrong You

54:46

know, it was very clear this boy had just come

54:48

from karate class And

54:50

the cops tell him oh he's been

54:52

belligerent and misbehaving and you know, we

54:54

the judge decided You know, he needs

54:57

to come to Crownsville clearly something's mentally wrong

54:59

with them This is in the 80s

55:03

You know Whenever

55:05

I think about this story and I think about that six-year-old a

55:07

lot Like I just have this image in my mind of what

55:10

the doctor described to me just a very small boy

55:12

You know not a big boy not taller

55:14

than the most six-year-olds or you know

55:16

It's the kind of kid who could

55:18

be mistaken for a teenager or something.

55:20

This is a kindergarten age

55:22

child in a karate uniform Who

55:26

apparently misbehaved in his class

55:28

and then gets arrested and brought to an adult

55:31

asylum By police officers

55:33

in Maryland unbelievable. It tells you a

55:35

lot about how people look at black

55:37

children any black child who's against behaving

55:40

misbehaving or making a mistake or Not

55:43

emotionally regulating in the way people might like

55:46

them to And that

55:48

they don't get great. They don't get second chances.

55:50

They don't get You know

55:52

phone call the mom This would

55:54

be the first stop and the good news is the doctors

55:57

are able to get him out of there and reconnecting with

55:59

his family and they get on the phone and

56:01

kind of explain to the judge, this is not appropriate. This is

56:03

not the right place to send a child.

56:06

What are you doing here? But that's kind

56:08

of what they're battling up against at that

56:10

time. And this is all very interconnected because

56:13

all of these hospitals, they've been closed down.

56:15

And I think often people will tell you

56:17

that as a win. We shut down the

56:20

old asylum model. You

56:22

know, they all have so many problems and abuses

56:24

in this terrible history. And there's a

56:26

lot of truth to that. But the problem

56:28

is for most Americans,

56:30

we didn't really build much to replace

56:32

that system. We never got community mental

56:35

health care centers, we were promised. We

56:37

never got clinic. There

56:39

weren't all the programs to support people

56:41

to get through medical school and all

56:43

these difficult and prestigious programs. And

56:46

so what ends up happening, especially to

56:48

black Americans, is that they're shifted

56:51

from the asylum and they're pushed

56:53

into places like prisons and jails.

56:55

And we're all living with

56:58

the consequences of that. When

57:00

did Crownville close? It closes in

57:02

2004. But from the

57:04

80s to the 2000s, it's kind of

57:07

limping every year to the finish line.

57:09

Like they're fighting for their survival. They're

57:11

struggling. They're losing funding

57:13

year after year. The

57:16

lawmakers in Maryland are slashing their resources

57:18

and telling them that they need to

57:20

create better outcomes with less. And

57:22

it's interesting how the moment it becomes

57:24

a black only institution. There were more

57:26

allies in Crownville at the moment

57:28

when it was dying, I guess.

57:31

Right. So it becomes kind of a

57:34

black community hospital for the first time. Then

57:36

the goalposts move again. One

57:39

of the things I look at

57:41

a lot in the book is

57:43

how goalposts move on black people, both

57:45

spiritually and literally. So they get this

57:47

opportunity to finally integrate and be doctors

57:50

and be administrators. And then now

57:52

they're being told you need to improve

57:54

outcomes while we also give you less money.

57:56

You need to make miracles happen with nothing.

58:00

want to get your patient numbers down,

58:02

but also we're going to let judges

58:04

send kids to the hospital every week.

58:06

You know, none of it's making sense.

58:08

They're all working in kind of impossible

58:10

circumstances. And so the

58:12

hospital closes and it's

58:15

a really heartbreaking and strange

58:17

and frightening moment because

58:20

the message to the patient is, yeah, you're going to

58:22

leave the asylum. You go back to the community. But

58:25

the people who actually know the patients and work with

58:27

them know that for so many poor black Americans, there

58:29

isn't a whole lot of infrastructure community

58:31

to go back to. There is no

58:34

doctor and clinic waiting for them to

58:37

help them on their journey to getting home

58:40

again. They're going to be left alone. And

58:42

that's what we find happening.

58:45

Yeah, it's almost like the irony

58:47

of segregation and desegregation, you know,

58:50

as bad as segregation was the

58:53

heroes of segregation were all the black businesses

58:55

that, you know, that were started

58:57

in the way that money was shared in

58:59

the black community. And, you know, my father,

59:02

my parents are from Chicago from that area.

59:04

And, you know, if you need a lawyer,

59:06

you went to a black lawyer, dentists, you

59:08

went to black dentists, you know, all these

59:11

things because you had to, you had no

59:13

choice, you know, but those those businesses were

59:15

thriving. And one of the fallouts of

59:17

integration as noble as

59:19

it was and important, of course, is

59:21

a lot of that infrastructure that

59:24

kept those communities vibrant in some ways

59:26

kind of fell away. Yeah. So

59:28

one of my family the other day was like, sometimes I

59:30

wonder if we spent too much time thinking about the separate

59:33

and not enough about the uneaten. Yes. Very

59:36

nice. Yes. Yeah. Right.

59:40

Yeah, there's heroes and villains and

59:42

all of these stories, you know,

59:44

and process of minuses. Is there

59:46

what is there any does this book give you

59:49

or the process of even

59:51

doing this book give you insight into

59:53

any types of solutions for the future,

59:55

especially when we're talking about the the

59:57

poor communities, people without resources, what we're

59:59

really. talking about because I think if

1:00:02

a lot of race these days, sometimes

1:00:04

you have to acknowledge class, I think

1:00:06

in these conversations too. Because I

1:00:09

think in, I'll call it the educated

1:00:11

class, not middle, upper or lower, but

1:00:13

in more of the educated class, people

1:00:15

are accepting, I think therapy a lot more

1:00:17

now, black mental health is

1:00:20

starting to be taken more seriously

1:00:22

in some aspects. And ironically, generationally,

1:00:24

it is still being resisted in

1:00:26

some ways. What's the way

1:00:28

forward to having this be more of a, both

1:00:32

an accepted thing and an accessible

1:00:34

thing? Well, the solutions on

1:00:36

the accessibility side, they're not

1:00:38

rocket science. Although you would think when you

1:00:40

look at our political environment and you listen

1:00:42

to our leaders, that the

1:00:45

greatest mystery in the universe, that

1:00:47

there seems to be nothing we can do about mental health, nothing

1:00:50

we can do about how many people get shot in public

1:00:52

all the time, we should

1:00:54

all just throw our hands up and accept it. But

1:00:56

when you talk to people who actually not

1:00:59

only work with patients day to

1:01:01

day right now, but also people who

1:01:03

saw what the system was like in an

1:01:05

earlier period before we, what we have

1:01:07

right now, they said

1:01:09

there's a couple very obvious and

1:01:12

not that expensive things that we

1:01:14

could all support or start doing

1:01:16

or start demanding our leaders take

1:01:18

more seriously. The first

1:01:20

is that, especially in black

1:01:22

communities, things like access to

1:01:24

green space, safe parks, safe

1:01:27

social spaces where there is not surveillance

1:01:29

of children, that doesn't mean no

1:01:31

parents or adults, but not police

1:01:35

officers and a whole sort of a

1:01:38

carceral apparatus around children, making

1:01:41

it very difficult for them to make mistakes or

1:01:43

experiment or try things and or fail.

1:01:47

So creating community centers that are actually

1:01:49

appealing and safe and fun for kids.

1:01:51

And safe and safe from crying too,

1:01:53

from maybe gang influence or that

1:01:55

sort of thing. Exactly. Funding

1:01:59

your own. public schools, these are

1:02:01

things that have

1:02:03

huge protective abilities,

1:02:06

their protective factors. So what doctors mean by

1:02:08

that is, you know, these are

1:02:10

the things that prevent children from developing

1:02:12

mental illness ever in the first place,

1:02:14

which is, which should be a large part

1:02:16

of a public health goal, especially coming out

1:02:18

of the pandemic. The

1:02:20

other piece of that is that, according

1:02:23

to doctors like Dr. Kimmy Benton, research

1:02:25

shows that children of

1:02:27

color, so not just black children,

1:02:29

but Asian American children, Hispanic children,

1:02:31

Native American children, for

1:02:33

children of color, knowing about your history

1:02:35

and your context in this country is

1:02:38

another major protective factor. Children

1:02:40

who do not know about where they come

1:02:42

from, why they matter, who their

1:02:45

ancestors were, the good, the bad,

1:02:47

and all of what's in between,

1:02:49

but those children are much more

1:02:51

likely to suffer from things like

1:02:53

depression and anxiety. And

1:02:55

that's because of all the messaging that

1:02:57

this country and our media can sometimes

1:03:00

send to those kids. So one of the

1:03:02

most important protective things that parents can do, that educators

1:03:04

can do is give your kids

1:03:06

books and talk about who you

1:03:08

are and where you come from and make

1:03:10

your kids feel like they matter. And

1:03:13

that's not rocket science. And those things are not

1:03:16

very expensive. It's a whole lot more expensive,

1:03:18

for example, to build a new juvenile justice facility

1:03:20

or a new prison in your neighborhood than

1:03:23

it would be to fund your park and to

1:03:25

fund your public schools. And

1:03:27

so these are choices. When

1:03:29

you talk to doctors, you find that these

1:03:32

are choices that we've made. They're not just

1:03:34

casual coincidences, which is what some people wouldn't

1:03:36

want you to believe or have you

1:03:38

believe. There are things that we decided

1:03:40

at some point we would do. And

1:03:42

the good news about that is that

1:03:44

you can change your decisions. You can

1:03:47

undo choices. It

1:03:49

does take a kind of

1:03:51

a new framework around community

1:03:54

care, around what

1:03:56

we want to spend our money on, about

1:03:58

how we hold our politicians accountable. in

1:04:00

order to do that. And

1:04:02

then, you know, there are a number

1:04:05

of programs, efforts to bring more people

1:04:07

of color into medical schools, whether

1:04:09

that's forgiving debt and just making it

1:04:11

affordable to become these

1:04:14

kinds of professionals. That

1:04:16

can play a major role in it, especially in fields

1:04:18

like psychiatry, where we're still talking two to

1:04:20

4%. I mean, and part of

1:04:23

the country, if you are black, you simply are just

1:04:25

not going to find a black psychiatrist or therapist, because

1:04:27

they don't exist, they're not there. You

1:04:29

can be here in New York City, people are on

1:04:31

months-long waiting lists to see any

1:04:34

kind of psychiatrist. Nevermind if you are

1:04:36

someone who has a language barrier and

1:04:38

might need someone who speaks Spanish. Your

1:04:40

personal suffering comes from a place that

1:04:42

would require your clinician have

1:04:44

some kind of cultural competency or

1:04:47

racial context. See, you're

1:04:49

gonna be on an even longer waiting list

1:04:51

because those professionals are really struggling to serve

1:04:54

their patient populations right now. And

1:04:56

none of those things are unsolvable. And

1:04:59

a lot of what makes a difference for patient

1:05:01

outcomes, and you'll see this in the book too,

1:05:04

in the stories of patients who actually do

1:05:06

make recoveries at Crownsville, when they tell their

1:05:08

stories, they don't remember the meditation

1:05:10

name that they were put on. What

1:05:13

they do remember are that people

1:05:15

who had their back, who forgave

1:05:17

them, who showed them unconditional support

1:05:21

and patience, and they do remember people

1:05:23

who reminded them every day out on the

1:05:25

wards that they were worthy, that this was

1:05:27

just a small part of their story, that

1:05:29

they still had so much more to

1:05:31

give and to do and to accomplish. And

1:05:34

the patients who are successful had

1:05:36

community. They had support. The patients

1:05:38

who were not successful did not.

1:05:41

And so right now we

1:05:43

spend a lot of time thinking about the

1:05:45

pharmaceutical side of things, about the medication, about

1:05:48

symptoms, about new drugs and development. But

1:05:50

without the community piece, most of the

1:05:52

experts who work in the space think

1:05:54

we're just kind of, it's like we're

1:05:56

on a hamster wheel. We're not really

1:05:58

getting anywhere. The drugs

1:06:00

just, you know, as

1:06:02

revolutionaries, some of them may be, to

1:06:04

me, all they're doing is stressing the

1:06:07

symptoms, you know? They're not really going

1:06:09

after the causes. But community,

1:06:11

to me, solves so many things.

1:06:14

And it's, you know, in so many areas,

1:06:16

not just the black community, but I feel

1:06:18

like so many local

1:06:20

communities are just being broken down all over

1:06:23

the place, you know? When I just

1:06:25

look at things, not to be doom

1:06:28

and gloom, but it is where a

1:06:30

lot of things can be accomplished by

1:06:32

a group of people with a shared vision about,

1:06:35

you know, wanting their

1:06:37

place that they live to be nice

1:06:39

or good for their children or have

1:06:41

good schools or all these things, you

1:06:43

know, so important in acknowledging

1:06:46

people and all those sorts of things. But who am

1:06:48

I? Who am I to say these things are good,

1:06:50

you know? You know, you're on

1:06:52

something and you got, I'm telling you, it's like,

1:06:54

every time I would call one of these doctors,

1:06:57

we'd be like, oh, I'm so excited to talk

1:06:59

to you about this. Because my

1:07:01

research shows something so simple. And we

1:07:03

could do this tomorrow if we wanted

1:07:05

to do it. And so, you know,

1:07:07

for people who care about these things, or maybe

1:07:09

you have a loved one in your own life who's

1:07:12

struggling, there are some

1:07:14

small things we could all do just

1:07:16

on our own tomorrow. You know, being

1:07:19

a person to a child, so that could

1:07:21

be your own child or your niece or

1:07:24

your nephew or just your best friend's kid,

1:07:26

being an adult who that kid

1:07:28

trusts, that makes a huge difference.

1:07:31

One of the major patterns that clinicians find is

1:07:34

that a lot of kids who end up in

1:07:36

crisis mode, they don't feel like

1:07:38

they have any adults in their lives. So

1:07:40

they could call and really tell what's going

1:07:42

on in school. Really tell what, how

1:07:44

they feel, what, really tell what

1:07:46

mistake they made. What

1:07:49

situation they got themselves into. Because

1:07:51

they don't really trust adults around them or

1:07:53

they are worried about being judged or cast

1:07:55

aside or whatever it might be.

1:07:58

And so to be an adult for... child

1:08:00

right now, again, especially after the pandemic

1:08:02

and all that kids have just gone

1:08:04

through to be a person who kids

1:08:06

trust and would call if they

1:08:09

needed someone to help them out or just

1:08:11

to listen to them or to have their

1:08:13

back. That's not a small thing. And

1:08:16

that's and we can't just put it all on us

1:08:18

and say, Oh, all of us can just take these

1:08:20

individual steps. And that's going to make the fact that

1:08:22

we have all these systemic failures fine. No, it is

1:08:24

not. But if you do care about these

1:08:27

things, when you want to feel like you did something

1:08:29

while we wait for everyone else to get there,

1:08:31

frankly, you can just try to be

1:08:36

that person for someone else. That's the other piece of

1:08:38

advice that I give for people. That's the other lesson

1:08:40

that I learned from so many of

1:08:42

the nurses and staff at Crownsville. These

1:08:45

black men and women, they came to

1:08:48

this impossible job every day. They worked

1:08:50

beyond the hours they were paid. And

1:08:52

they got results, not because

1:08:54

the state gave them funding

1:08:57

and really back their programs and got

1:08:59

them the best of what was available,

1:09:01

but just because they really

1:09:03

tried to have their patients back and

1:09:05

tell this very vulnerable

1:09:07

group of patients that they were

1:09:10

loved, that they were worthy of something greater. And

1:09:13

that message does a whole

1:09:15

lot to protect people's well being. And

1:09:17

it means more than most people know. So

1:09:21

important. So important. Use important.

1:09:25

Use somebody. Antonio,

1:09:29

thank you so much. Sorry to do another

1:09:31

joke. It's

1:09:33

such a fascinating, just

1:09:36

journey, this book. Fascinating

1:09:38

journey that everyone should

1:09:40

know about. The book, Everybody's

1:09:43

Madness, Race and Insanity, and the

1:09:45

Jim Crow Asylum, and Tony Hilton. It's

1:09:47

not only very

1:09:50

amazing research, as I was pointing out

1:09:52

some of the details in that, but

1:09:55

you're such a great storyteller too. I got to give you

1:09:57

props for that. You know, you can just listen to your

1:10:00

you talk about it, just a really

1:10:02

great storyteller. And I thought

1:10:04

it was really, it was moving,

1:10:06

including your family and your personal journey in

1:10:08

this book too, I was really moved by

1:10:10

that. Thank you, that means the world to

1:10:13

me, especially coming from you, so thank

1:10:16

you. And yeah,

1:10:19

I try to just speak

1:10:21

about this story, about this work from a very personal

1:10:23

place. I wanted to be up front with my readers.

1:10:25

You're going on a journey with me, and I'm not

1:10:27

gonna lie to you, I didn't stumble upon this like

1:10:29

a journalist who just found out about a cool scoop.

1:10:32

It comes from this very personal place.

1:10:36

And also a hopeful place, a

1:10:38

belief that if we deal with all this

1:10:40

and we understand it better, we actually can

1:10:42

do something about it. That's important, you guys,

1:10:44

hopeful, hopeful, hopeful, hopeful,

1:10:47

yeah, there's a lot of

1:10:49

harsh realities in here, but hopeful

1:10:52

can come out of the madness. There is

1:10:54

a way to come together in here, and

1:10:57

that's why I love that you talked about

1:10:59

community. Antonia Hilton, you guys, Madness is the

1:11:01

book. Remember, I don't steer you guys

1:11:03

wrong when I tell you what to read, this is

1:11:05

one of them. Thank you so much, Antonia. Thank you,

1:11:07

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