Ten Days in a Madhouse: The Woman Who Got Herself Committed

In 1887, intrepid reporter Nellie Bly pretended she was crazy and got herself committed, all to help improve conditions in a New York City mental institution.

“The insane asylum on Blackwell’s Island is a human rat-trap. It is easy to get in, but once there it is impossible to get out.”

Those words, describing New York City’s most notorious mental institution, were written by journalist Nellie Bly in 1887. It was no mere armchair observation, because Bly got herself committed to Blackwell’s and wrote a shocking exposé called Ten Days In A Madhouse. The series of articles became a best-selling book, launching Bly’s career as a world-famous investigative reporter and also helping bring reform to the asylum.

In the late 1880s, New York newspapers were full of chilling tales about brutality and patient abuse at the city’s various mental institutions. Into the fray came the plucky 23-year Nellie Bly (born Elizabeth Cochrane, she renamed herself after a popular Stephen Foster song). At a time when most female writers were confined to newspapers’ society pages, she was determined to play with the big boys. The editor at The World liked Bly’s moxie, and challenged her to come up with an outlandish stunt to attract readers and prove her mettle as a “detective reporter.”

The stylish and petite Bly, who had a perpetual smile, set about her crazy-eye makeover. She dressed in tattered second-hand clothes. She stopped bathing and brushing her teeth. And for hours, she practiced looking like a lunatic in front of the mirror. “Faraway expressions look crazy,” she wrote. Soon she was wandering the streets in a daze. Posing as Nellie Moreno, a Cuban immigrant, she checked herself into a temporary boarding house for women. Within twenty-four hours, her irrational, hostile rants had all of the other residents fearing for their lives. “It was the greatest night of my life,” Bly later wrote.

The police hauled Bly off, and within a matter of days, she bounced from court to Bellevue Hospital’s psychiatric ward. When she professed to not remembering how she ended up in New York, the chief doctor diagnosed her as “delusional and undoubtedly insane.” Meanwhile, several of the city’s other newspapers took an interest in what one called the “mysterious waif with the wild, hunted look in her eyes.” Bly had everyone hoodwinked, and soon enough, she was aboard the “filthy ferry” to Blackwell’s Island.

The Lonely Island

Opened as America’s first municipal mental hospital in 1839, Blackwell’s Island (known today as Roosevelt Island) was meant to be a state-of-the-art institution committed to moral, humane rehabilitation of its patients. But when funding got cut, the progressive plans went out the window. It ended up as a scary asylum, staffed in part by inmates of a nearby penitentiary.

Although other writers had reported on conditions at the asylum (notably Charles Dickens, in 1842, who described its “listless, madhouse air” as “very painful”), Bly was the first reporter to go undercover. What she found exceeded her worst expectations. There were “oblivious doctors” and “coarse, massive” orderlies who “choked, beat and harassed” patients, and “expectorated tobacco juice about on the floor in a manner more skillful than charming.” There were foreign women, completely sane, who were committed simply because they couldn’t make themselves understood. Add to that rancid food, dirty linens, no warm clothing and ice-cold baths that were like a precursor to water boarding. Bly described the latter:

“My teeth chattered and my limbs were goose-fleshed and blue with cold. Suddenly I got, one after the other, three buckets of water over my head – ice-cold water, too – into my eyes, my ears, my nose and my mouth. I think I experienced the sensation of a drowning person as they dragged me, gasping, shivering and quaking, from the tub. For once I did look insane.”

And worst of all, there was the endless, enforced isolation:

“What, excepting torture, would produce insanity quicker than this treatment? . . . Take a perfectly sane and healthy woman, shut her up and make her sit from 6 a.m. to 8 p.m. on straight-back benches, do not allow her to talk or move during these hours, give her no reading and let her know nothing of the world or its doings, give her bad food and harsh treatment, and see how long it will take to make her insane. Two months would make her a mental and physical wreck.”

As soon as Bly arrived at Blackwell’s Island, she dropped her crazy act. But to her horror, she found that only confirmed her diagnosis. “Strange to say, the more sanely I talked and acted, the crazier I was thought to be,” she wrote.

Near the end of her stay, her cover was almost blown. A fellow reporter she’d known for years was sent by another newspaper to write about the mysterious patient. He himself posed as a man in search of a lost loved one. Bly begged her friend not give her away. He didn’t. Finally, after ten days, The World sent an attorney to arrange for Nellie Moreno’s release.

Going Public

Two days later, the paper ran the first installment of Bly’s story, entitled “Behind Asylum Bars.” The psychiatric doctors who’d been fooled offered apologies, excuses and defenses. The story traveled across the country, with papers lauding Bly’s courageous achievement. Almost overnight, she became a star journalist.

But for Bly, it wasn’t about the fame. “I have one consolation for my work,” she wrote. “On the strength of my story, the committee of appropriation provides $1,000,000 more than was ever before given, for the benefit of the insane.”

Actually, the city had already been considering increasing the budget for asylums, but Bly’s article certainly pushed things along.

A month after her series ran, Bly returned to Blackwell’s with a grand jury panel. In her book, she says that when they made their tour, many of the abuses she reported had been corrected: the food services and sanitary conditions were improved, the foreign patients had been transferred, and the tyrannical nurses had disappeared. Her mission was accomplished.

Bly would go on to more sensational exploits, most notably, in 1889, circling the globe in a record-setting seventy-two days (she meant to beat out Jules Verne’s fictional trip in Around The World in Eighty Days). In later years, she retired from journalism and founded her own company, designing and marketing steel barrels used for milk cans and boilers. She died in 1922. Bly’s amazing life has since been the subject of a Broadway musical, a movie and a children’s book.

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Interactive Map Shows Where Your House Would Have Been 750 Million Years Ago
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Your neighborhood traveled a long way over several hundred million years to reach the spot it occupies today. To trace that journey over the ages, check out Ancient Earth, an interactive digital map spotted by Co.Design.

Ancient Earth, a collaboration between engineer and Google alum Ian Webster and Paleomap Project creator C.R. Scotese, contains geographical information for the past 750 million years. Start at the beginning and you'll see unrecognizable blobs of land. As you progress through the ages, the land mass Pangaea gradually breaks apart to form the world map we're all familiar with.

To make the transition even more personal, you can enter your street address to see where it would have been located in each period. Five hundred million years ago, for example, New York City was a small island in the southern hemisphere isolated from any major land mass. Around the same time, London was still a part of Pangaea, and it was practically on top of the South Pole. You can use the arrows on your keyboard to flip through the eras or jump from event to event, like the first appearance of multicellular life or the dinosaur extinction.

As you can see from the visualization, Pangaea didn't break into the seven continents seamlessly. Many of the long-gone continents that formed in the process even have names.

[h/t Co.Design]

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Illustration by Mental Floss / Images: iStock
11 Facts About the Appendix
Illustration by Mental Floss / Images: iStock
Illustration by Mental Floss / Images: iStock

Despite some 500 years of study, the appendix might be one of the least understood structures in the human body. Here's what we know about this mysterious organ.

1. THE ANCIENT EGYPTIANS CALLED IT THE "WORM" OF THE BOWEL.

The human appendix is small, tube-shaped, and squishy, giving ancient Egyptians, who encountered it when preparing bodies for funerary rites, the impression of a worm. Even today, some medical texts refer to the organ as vermiform—Latin for "worm-like."

2. THE APPENDIX SHOWS UP IN LEONARDO DA VINCI’S DRAWINGS.

The earliest description of a human appendix was written by the Renaissance physician-anatomist Jacopo Berengario da Carpi in 1521. But before that, Leonardo da Vinci is believed to drawn the first depiction of the organ in his anatomical drawings in 1492. Leonardo claimed to have dissected 30 human corpses in his effort to understand the way the body worked from mechanical and physiological perspectives.

3. IT'S ABOUT THE SIZE OF A PINKY FINGER.

The appendix is a small pouch connected to the cecum—the beginning of the large intestine in the lower right-hand corner of your abdomen. The cecum’s job is to receive undigested food from the small intestine, absorb fluids and salts that remain after food is digested, and mix them with mucus for easier elimination; according to Mohamad Abouzeid, M.D., assistant professor and attending surgeon at NYU Langone Medical Center, the cecum and appendix have similar tissue structures.

4. CHARLES DARWIN THOUGHT IT WAS A VESTIGIAL ORGAN …

The appendix has an ill-deserved reputation as a vestigial organ—meaning that it allegedly evolved without a detectable function—and we can blame Charles Darwin for that. In the mid-19th century, the appendix had been identified only in humans and great apes. Darwin thought that our earlier ancestors ate mostly plants, and thus needed a large cecum in which to break down the tough fibers. He hypothesized that over time, apes and humans evolved to eat a more varied and easier-to-digest diet, and the cecum shrank accordingly. The appendix itself, Darwin believed, emerged from the folds of the wizened cecum without its own special purpose.

5. … BUT THE APPENDIX PROBABLY EVOLVED TO HELP IMMUNE FUNCTION.

The proximity and tissue similarities between the cecum and appendix suggest that the latter plays a part in the digestive process. But there’s one noticeable difference in the appendix that you can see only under a microscope. “[The appendix] has a high concentration of the immune cells within its walls,” Abouzeid tells Mental Floss.

Recent research into the appendix's connection to the immune system has suggested a few theories. In a 2015 study in Nature Immunology, Australian researchers discovered that a type of immune cells called innate lymphoid cells (ILCs) proliferate in the appendix and seem to encourage the repopulation of symbiotic bacteria in the gut. This action may help the gut recover from infections, which tend to wipe out fluids, nutrients, and good bacteria.

For a 2013 study examining the evolutionary rationale for the appendix in mammal species, researchers at Midwestern University and Duke University Medical Center concluded that the organ evolved at least 32 times among different lineages, but not in response to dietary or environmental factors.

The same researchers analyzed 533 mammal species for a 2017 study and found that those with appendices had more lymphatic (immune) tissue in the cecum. That suggests that the nearby appendix could serve as "a secondary immune organ," the researchers said in a statement. "Lymphatic tissue can also stimulate growth of some types of beneficial gut bacteria, providing further evidence that the appendix may serve as a 'safe house' for helpful gut bacteria." This good bacteria may help to replenish healthy flora in the gut after infection or illness.

6. ABOUT 7 PERCENT OF AMERICANS WILL GET APPENDICITIS DURING THEIR LIFETIMES.

For such a tiny organ, the appendix gets infected easily. According to Abouzeid, appendicitis occurs when the appendix gets plugged by hardened feces (called a fecalith or appendicolith), too much mucus, or the buildup of immune cells after a viral or bacterial infection. In the United States, the lifetime risk of getting appendicitis is one in 15, and incidence in newly developed countries is rising. It's most common in young adults, and most dangerous in the elderly.

When infected, the appendix swells up as pus fills its interior cavity. It can grow several times larger than its average 3-inch size: One inflamed appendix removed from a British man in 2004 measured just over 8 inches, while another specimen, reported in 2007 in the Journal of Clinical Pathology, measured 8.6 inches. People with appendicitis might feel generalized pain around the bellybutton that localizes on the right side of the abdomen, and experience nausea or vomiting, fever, or body aches. Some people also get diarrhea.

7. APPENDECTOMIES ARE ALMOST 100 PERCENT EFFECTIVE FOR TREATING APPENDICITIS.

Treatment for appendicitis can go two ways: appendectomy, a.k.a. surgical removal of the appendix, or a first line of antibiotics to treat the underlying infection. Appendectomies are more than 99 percent effective against recurring infection, since the organ itself is removed. (There have been cases of "stump appendicitis," where an incompletely removed appendix becomes infected, which often require further surgery.)

Studies show that antibiotics produce about a 72 percent initial success rate. “However, if you follow these patients out for about a year, they often get recurrent appendicitis,” Abouzeid says. One 2017 study in the World Journal of Surgery followed 710 appendicitis patients for a year after antibiotic treatment and found a 26.5 percent recurrence rate for subsequent infections.

8. AN INFECTED APPENDIX DOESN’T ACTUALLY BURST.

You might imagine a ruptured appendix, known formally as a perforation, being akin to the "chestbuster" scene in Alien. Abouzeid says it's not quite that dramatic, though it can be dangerous. When the appendix gets clogged, pressure builds inside the cavity of the appendix, called the lumen. That chokes off blood supply to certain tissues. “The tissue dies off and falls apart, and you get perforation,” Abouzeid says. But rather than exploding, the organ leaks fluids that can infect other tissues.

A burst appendix is a medical emergency. Sometimes the body can contain the infection in an abscess, Abouzeid says, which may be identified through CT scans or X-rays and treated with IV antibiotics. But if the infection is left untreated, it can spread to other parts of the abdomen, a serious condition called peritonitis. At that point, the infection can become life-threatening.

9. SURGEONS CAN REMOVE AN APPENDIX THROUGH A TINY INCISION.

In 1894, Charles McBurney, a surgeon at New York's Roosevelt Hospital, popularized an open-cavity, muscle-splitting technique [PDF] to remove an infected appendix, which is now called an open appendectomy. Surgeons continued to use McBurney's method until the advent of laparoscopic surgery, a less invasive method in which the doctor makes small cuts in the patient's abdomen and threads a thin tube with a camera and surgical tools into the incisions. The appendix is removed through one of those incisions, which are usually less than an inch in length.

The first laparoscopic appendectomies were performed by German physician Kurt Semm in the early 1980s. Since then, laparoscopic appendectomies have become the standard treatment for uncomplicated appendicitis. For more serious infections, open appendectomies are still performed.

10. AN APPENDIX ONCE POSTPONED A ROYAL CORONATION.

When the future King Edward VII of Great Britain came down with appendicitis (or "perityphlitis," as it was called back then) in June 1902, mortality rates for the disease were as high as 26 percent. It was about two weeks before his scheduled coronation on June 26, 1902, and Edward resisted having an appendectomy, which was then a relatively new procedure. But surgeon and appendicitis expert Frederick Treves made clear that Edward would probably die without it. Treves drained Edward's infected abscess, without removing the organ, at Buckingham Palace; Edward recovered and was crowned on August 9, 1902.

11. THE WORLD'S LONGEST APPENDIX MEASURED MORE THAN 10 INCHES.

On August 26, 2006, during an autopsy at a Zagreb, Croatia hospital, surgeons obtained a 10.24-inch appendix from 72-year-old Safranco August. The deceased currently holds the Guinness World Record for "largest appendix removed."

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