Virginia Relics Part Two: Eugenics

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Skeleton in the Library 2014/Josephine Ensign

Health and Homelessness in Richmond, Virginia in the 1980s: A companion to Virginia’s Racial Integrity law (see previous blog post ‘Virginia Relics Part One: Racism’), The Eugenical Sterilization Act, was also passed into Virginia law in 1924. This was part of Social Darwinism, The Progressive Movement and eugenics: bettering society through social and scientific engineering. Margaret Sanger, the nurse and founder of Planned Parenthood, was part of this movement. The pseudo-science of phrenology–measuring the skull to predict IQ and criminality–was part of eugenics.

Virginia’s Sterilization Act mandated involuntary sterilization of people institutionalized with mental retardation,*  severe mental illness, and epilepsy. It also applied to prison inmates. They were all the defectives or delinquents, viewed as a drain on society–they should be eliminated. People who were institutionalized and considered feeble-minded included the shiftless poor, homeless, runaway teens, chronic inebriates, and oversexed women. Physicians could involuntarily sterilize women of normal intelligence who were deemed promiscuous. Promiscuity was defined as having a baby outside of marriage, having multiple sexual partners, being a white woman with a black partner, or working in prostitution.

When Virginia passed the Sterilization Act, eugenicist physicians looked for a suitable test case to seal it into law. The physician in charge of the Virginia State Colony for Epileptics and Feebleminded found his ideal candidates in three generations of Buck women. The elder and widowed Mrs. Buck had been confined to the Colony for having illegitimate children. One of her daughters, Carrie, had gotten pregnant at age sixteen—the result of rape by a young man in her foster family. A Red Cross nurse declared Carrie’s daughter, Vivian, feebleminded at six months of age. The nurse reported in official expert testimony that Vivian was “peculiar,” with “a look about it that’s not quite normal.” The head of the Virginia Colony wanted to sterilize all three of the Buck women. The case went to the U.S. Supreme Court, where Chief Justice Oliver Wendell Holmes, Jr. likened involuntary sterilization of degenerate offspring to state sanctioned immunizations. The Supreme Court Justices ruled in favor of Virginia, so the Buck women were sterilized—except for Vivian who died at age eight in the care of the same foster family where her mother had been raped.

After the Supreme Court ruling, Virginia physicians aggressively pursued the Sterilization Act, giving Virginia the highest per capita rate of involuntary sterilization of the “feeble-minded” and other undesirables. One of the main Virginia eugenics physicians, Dr. Albert Priddy, wrote to physicians in Nazi Germany praising their work and bemoaning the fact that the U.S. lagged behind the Nazis in the eugenics movement. During the Nuremburg Trials after World War II, defense attorneys for Nazi doctors cited the Buck vs. Bell U.S. Supreme Court ruling as justification for the Nazi doctors’ involuntary sterilization of hundreds of thousands of people. Buck vs. Bell has never been overruled. Virginia’s Eugenical Sterilization Act wasn’t repealed until 1979, just a few years before I started nursing school.

Before my work at the Richmond Street Center, I was vaguely familiar with these parts of Virginia history—of how my home state tried to not only designate and separate the desirables from the undesirables, but also to extinguish the undesirables. Some of the activist social workers at the Daily Planet talked about it. But it was embarrassing, something I preferred not to think about. I was able to avoid thinking about these laws because I viewed them as relics from a past that didn’t affect me. My work at the Street Center–and especially with a patient named Sally**– changed that. Sallie lived with her alcoholic mother in the heart of the all-white and impoverished Oregon Hill, located across Belvidere Street from the Street Center. Sally had an IQ of 45. One day several years into my work at the Street Center, Sally came into our clinic complaining of belly pain. I discovered she was four months pregnant. She was obese and wore baggy clothes, so no one had noticed her expanding belly.

Within the first year of opening, the Street Center had become a popular hangout for Richmond’s marginally housed adults, including many who had mental retardation and mental illness. They moved around to live with different relatives, or they lived in cheap, moldering old downtown hotels. Others lived in Richmond’s numerous group homes. Many of these homes were located less than a mile from the Street Center, a straight shot north up Belvidere Street where it turned into Chamberlayne Avenue. Chamberlayne had huge, stately old brick homes, now abandoned in the White Flight after school desegregation. The houses had been converted into group homes, domestic abuse shelters, a teen runaway shelter, and even an animal shelter. It was a social service ghetto.

Group homes had opened in response to deinstitutionalization efforts in the 1970s and early 1980s, as mentally retarded and chronically mentally ill people were moved out of state-run long term care institutions and back into the community. The idea was a good one: provide supportive home-like living situations and community mental health care. But no one wanted group homes in their neighborhoods, so the homes ended up clustered in low-income areas. Most of the group homes in Richmond were poorly run, inadequately staffed, and lacked licensing oversight. There was also a deficit of community-based mental health and support services for the residents of group homes.

The Street Center social workers tried to be alert for clients like Sally with mental retardation or chronic mental illness and to tie them in with alternative services. These clients were vulnerable to being preyed upon by the street-hardened homeless men in the center. The Street Center had free meals, lax rules, and staff members who were earnest, kind-hearted young people. The building was always bustling with activity, so it was a magnet for people like Sallie.

By the time I discovered her pregnancy, Sally was past the window for being able to have an abortion–even if her deeply religious mother had agreed to one. As a nurse I was required by the state to report suspected child abuse and neglect, which this seemed headed toward. I didn’t like being part of a system that could take children from their parents. I didn’t like being an agent of social control, but I knew I had a duty to protect vulnerable children.

A simultaneous and distasteful part of my job was dealing with the childless, infertile white upper middle class Christian married women who hovered around our clinic in search of suitable babies to adopt. I was a mother by then, so I understood some of what it must feel like to desperately want a baby and not be able to have one. But the childless women would drop off bizarre advertising materials: pages of contact information, written statements, and formal studio photos of them beside their husbands. It felt obscene that they were shopping for babies at the Street Center and taking advantage of an already marginalized population. Since our clinic was run by a conservative Evangelical Christian organization, I allowed the women to leave their advertisements. What the women didn’t say directly but carefully implied was that they only wanted white babies. And they certainly didn’t want to adopt a baby from a white mentally retarded woman like Sally.

* Terms such as “mentally retarded” or “developmentally disabled” I use based on accepted terminology within the U.S. medical and legal realms of the particular time period I am writing about.

** Names and identifying details have been changed, and in this case I have chosen to use a composite patient.





Virginia Relics Part One: Racism

Virginia State Capitol, Richmond 2014/Josephine Ensign

Health and Homelessness in Richmond, Virginia in the 1980s: My hometown of Richmond, Virginia is a city anchored to its past by bronze and marble Confederate shrines of memory, by an undying devotion to the cult of the Lost Cause. I was born and raised in the furrowed, relic-strewn Civil War battlefields on the city’s tattered eastern edge. A captive of its public schools, I was taught official Virginia history from textbooks approved by the First Families of Virginia. But I came to understand the shadowed history of my state by caring for its homeless outcasts.

These lessons began while I was in nursing school in the early 1980s. The modern hospital of the Medical College of Virginia curled around the former White House of the Confederacy like a lover. My clinical rotations were nearby in the crumbling brick former Colored Only hospital, which then housed indigent and homeless patients, as well as prisoners. Most of these patients were black, so I called it (to myself) the Almost Colored Only Hospital. The prisoners, shackled to their beds and accompanied by brown-clad armed guards, were from the State Penitentiary located across town. One of my patients was a Death Row inmate. When I spoon-fed him his medications, I was simultaneously afraid for my own safety and ashamed of being an accomplice to murder. I knew I was nursing him back to health only to return him so he could be killed by the state. I also knew this was not something I could discuss with my oh-so-white clinical nursing instructor. Racism was never addressed in nursing school.

One evening in 1985, during my final year of nursing school, I was on Belvidere Street driving home from a clinical day on the south side of Richmond. At a stoplight I found myself surrounded by a crowd of scruffy white men. Some of them thrust hand-lettered cardboard signs towards my car, and chanted, “Kill the N—er!” as I drove past the Virginia State Penitentiary. On the other side of Spring Street stood a smaller crowd of people holding lit candles and singing hymns. I had been following the local news, so I knew what the protests were about. I just didn’t know they would spill out into the street—that I would be forced to see and hear them. I also didn’t realize how racist and hate-filled they’d be. That part was politely–conveniently– left out of local news.

That evening, June 25th, 1985, Virginia electrocuted Morris Mason, a thirty-two-year-old black man from the isolated, rural Eastern Shore of Virginia. Mr. Mason admitted to killing a white woman, waived his right to a trial, and was sentenced to death by a white judge. With an IQ of sixty-six, Morris Mason had the mental functioning of an eight year old. He also had paranoid schizophrenia, diagnosed during a brief stint in the Army. He’d been unable to get treatment after he was discharged. So Virginia was executing a mentally retarded and mentally ill man who had never stood trial for murder.

Virginia holds the dubious distinction of being the state with the most executions in its history, and maintains the highest per capita rate of executions in the country. Those executed in Virginia—as elsewhere in the South—are disproportionately poor and black, and typically have been charged by white judges with murder of white people.

The Richmond Street Center was located in the armpit of town, near the impoverished and racist all-white Oregon Hill, and across the Downtown Expressway from the State Penitentiary. During my years working at the Street Center, four more men were executed next door—one every year—usually during the hottest part of summer. All of the men were killed at night by electrocution with two 2,200-watt surges of electricity. Most of the men were killed in the months leading up to local elections. Politicians used the executions as evidence of being tough on crime. The death penalty did nothing to deter crime: Richmond continued to have one of the highest murder rates in the country. Murder rates everywhere in the world are directly linked with socio-economic and racial inequities–as well as to access to handguns.

Before the executions, my patients would joke about how the lights would dim in the area around the State Pen when anyone was electrocuted. They also teased me about the chair I had in my office. It was a 1930s era white enameled iron exam chair, donated by owners of an employee’s clinic at a Richmond tobacco processing plant that had recently closed. The arms of the chair swiveled. It had a padded, adjustable metal clamp headrest. The chair had been designed for ear, nose and throat exams. I had it in my office because it was handy to use for taking vital signs and for blood draws. Patients would often sit in it, place their heads back in the metal headrest, flap the chair arms back and forth, and call it Old Sparky. It was mostly white men who joked about the executions. Sometimes the Street Center took on a carnival atmosphere in the days before an execution. I chalked that up to remnants of racism and to the collective memory of lynchings.

Virginia’s Racial Integrity Act of 1924 was an anti-miscegenation law spearheaded by Dr. Walter Plecker, a white supremacist male physician and public health professional, who was head of Virginia’s Bureau of Vital Statistics, a division of the Virginia State Board of Health. The law mandated that a racial description of every person be recorded at birth, with babies sorted into one of two categories: white or colored (black or American Indian or anything else non-white), following the one-drop rule. They added the ‘Pocahontas Exception’ since many of Virginia’s first families claimed descent from her—so Virginians could be white if they had no more than 1/16th American Indian blood. The Racial Integrity Act wasn’t overturned until 1967.

When I think about my hometown of Richmond, Virginia (and when I revisit the city as I did this week), it makes me sad—and angry—that it continues to have the worst health statistics of any place in Virginia. The population is majority African American, and it has wide income inequities, along with all the social ills that accompany it, including homelessness. While Virginia ranks in the top ten nationally for per capita income, it has one of the lowest minimum wages and one of the worst Medicaid and state children’s health insurance coverage rates in the country. The Republican-controlled General Assembly has continued to block efforts to add ACA/healthcare reform Medicaid Expansion services (see NYT article linked below). Virginia ranks towards the bottom nationally in provision of mental health care services. Virginia has a deeply rooted history of bias against mental illness, mental retardation and developmental delay. In the wake of the Virginia Tech shootings in 2007, Virginia’s politicians were pressured to work towards improving the state’s mental health system, but they have a long way to go. They also have a long way to go in acknowledging and redressing the deep wounds of institutionalized racism.