Editor’s Note: Today’s guest post is a is a modified excerpt from Jessica Diller Kovler’s upcoming book, The Boys of the Bronx, to be published in 2015. Kovler is part of the History of Science program at Harvard University and currently teaches at John Jay College of Criminal Justice, the City University of New York. Her work has appeared in The New York Times, Forbes, and Discover magazines.
In my city—which, as you may have heard, doesn’t sleep—some nonetheless lethargic neighborhoods have had an awakening of sorts. Many New Yorkers are forgoing the bustling city centers for the far-flung shores of Manhattan as well as some of the city’s 41 adjacent islands, neighborhoods previously considered “The Devil’s Stepping Stones.” (Legend has it that indigenous New Yorkers chased the Devil across the waters of New York, and every time the Devil stepped down on the water, an island was born.) These areas were so removed from the grid that they were used to house the city’s derelict, destitute, profligate, and banished—drug addicts, criminals and those deemed too mentally or physically ill, or even too dangerous to live in “mainland” New York City.
Take Roosevelt Island, where Nellie Bly penned her work on the infamous Woman’s Lunatic Asylum; that island is now home to luxury rentals, with Cornell University planning an extension campus for 2017. Randall’s Island and Wards Island, home to cemeteries, asylums, and contagion hospitals, are now home to Little League games and the Electric Zoo festival.
Amidst this transformation, one island has been forgotten, though thousands of New Yorkers have (reluctantly) called it home. The last inhabitants of North Brother Island comprise a lost chapter in the story of urban institutionalization, a faded memory of a city grappling with a perceived epidemic of both juvenile delinquency and adolescent narcotics addiction. Now abandoned, its buildings fading behind overgrowth, the island nonetheless reveals why New York institutionalized drug-addicted teenagers, even as a nationwide movement towards deinstitutionalization was beginning to gain momentum.
First came the infected. When it was first built during the 1880s, Riverside Hospital served as a detention hospital to treat patients with infectious disease who came from the city’s poorest communities. The facility on North Brother Island, a 20-acre plot in the East River near the Bronx, was home to the famous quarantine patient, Typhoid Mary. Then came the vets. During a nationwide housing shortage, the novelist Evan Hunter (aka Ed McBain) lived on North Brother when the island briefly housed World War II veterans who were students at local colleges. Hunter remembered the island as a “figurative never-never land that was a part of the city, and yet removed from it.”
Then, for roughly a decade beginning in 1952, Riverside Hospital was home to a government-funded social experiment to cure young heroin addicts of narcotics addiction and juvenile delinquency. While treatment had existed for young addicts in New York since 1910, Riverside was the first hospital in the country devoted solely to the treatment of adolescents. This failed experiment is a crucial and often ignored moment in the addiction history narrative that raises important ethical and policy concerns that remain relevant 60 years later.
When the experiment began, New York appeared to be in crisis. The images of the post-war city are easily conjured: the flight of white families to the suburbs left city streets to be run by the Sharks and the Jets—kids seen by the greater society as up to no good, though they attested to authorities (such as Officer Krupke) that they were simply “misunderstood.”
Many believed that these juvenile delinquents were also junkies. Whether the connection between juvenile delinquency and heroin was real—and whether rates of heroin addiction actually increased—is a contentious topic. Still, it is clear that the media perpetuated the notion of the junkie JD, which metastasized in the minds of middle-class Americans.
When the perceived crisis peaked in 1951, medical, political, and legal officials hosted symposia to discuss solutions. At a series of meetings at the New York Academy of Medicine, all agreed that something needed to be done, but a lack of knowledge, and—in the words of one subcommittee chairman—“contradictory conclusions” complicated attempts at a solution. What was needed, they thought, was an isolated facility to allow for control as well as the use of a new social and medical corrective philosophy.
Many in law enforcement advocated a more incarcerary framework. Federal Bureau of Narcotics Chief Harry Anslinger equated addiction with communicable disease and said that those arrested for possession should be forced into treatment hospitals. One neighborhood politician remarked that a juvenile addict is “dangerous, much like a contagious person with yellow fever… and must be removed from society. Like a violent felon, he must be removed for he is at risk of harming others.”
Dr. Marcus Kogel, Commissioner of Hospitals, argued that the institution could take adolescents out of their environment just “long enough to enable them to assume command over the [outside] influences which have misguided them.” Another official said, “If we can find an island to put them on in New York, that is exactly what we do. We had the unwanted elderly on Staten Island, and we [could put] the unwanted addicts on North Brother Island.”
Riverside Hospital opened on July 1, 1952 with space for 150 patients (not meeting demand, as there were 600 juvenile drug-related arrests the year prior). Though his patients were adolescents, Dr. Jerome Leon, Riverside’s first superintendent, based part of the treatment model on the adult federal narcotics farm in Lexington, Kentucky. Adopting a quasi-contagion model, officials at the Kentucky facility believed that adolescents should not be placed with adults because exposure to longer-term addicts tainted the prospects of curing the youths. While treatment modalities varied little between the adolescent and adult populations, predicted treatment outcomes were quite different. Dr. Vincent Vogel of the federal facility believed there was a key difference between adolescent and adult addict; he supposed that adolescents had just tried the drug for a thrill and were not the “psychoneurotic type nor psychopaths like the older addicts.” Leon also thought the youths had a greater chance of being “cured.”
Following withdrawal, a patient’s schedule would include therapy, vocational classes, work, and school on the island at PS 619 (one of the 600-series schools created by New York City in the 1950s for juvenile delinquents). Press releases touted first-class facilities for home economics and shop crafts, as well as access to sports, movies and TV.
The Realities of Riverside
Despite the notion that isolation from an urban setting would set the stage for recovery, from the outset, patients were not content. As one observer noted: “It was apparent that a restless, and well-nigh desperate impatience lay behind the tragic efforts of some who attempted to escape by swimming the treacherous waters of the river.”
The hospital was overcrowded, financially corrupt by some accounts, and simply unsuccessful at “curing” patients. Prostitution and drug use were reportedly rampant among patients and the staff. One patient who spent three years in treatment on North Brother Island described the Riverside Hospital pharmacist as “a big trick” who sold drugs. Auditors found that the buildings had “many broken windows and dilapidated, hazardous interiors.”
The same audit also found inconsistencies in treatment, which largely depended on a patient’s randomly assigned treatment team. Treatment for patients with similar profiles could range from a few weeks to two years. Reasons for such critical inconsistencies included inadequate knowledge about addiction in juveniles (including no distinction in treatment between the younger and older adolescents) and lack of planning. Dr. Leon, the hospital superintendent, admitted he didn’t know “what stage of drug use” merited admission to the hospital. He felt that “anybody who had dabbled in the drug, used it, or became addicted to it could be admitted.” At the same time, he only accepted those he thought could be cured. “We can’t try to reform robbers, rapers [sic] and the like,” he said. Auditors found hospital leaders unfamiliar with addiction treatment, and reports criticized officials for their lack of research into “any of the aspects of juvenile drug addiction…sociology, psychodynamics, pharmacology, or even the results of treatment at Riverside Hospital.”
Patients also had little professional support in place after they left Riverside. The Columbia School of Pubic Health began a somewhat empirical evaluation of 247 patients who had first been admitted in 1955 and later released. Of these interviews, only 14 percent were conducted outside of a hospital or jail. Eleven patients were dead, a high number for this age group, most due to overdose. A quarter of patients had done jail time or forced hospitalization. Almost all reported using drugs after Riverside. Only eight claimed to be sober—but these eight said that they had never been addicted, only arrested for possession, and they had asked to go to Riverside thinking it would be easier than jail. The City was pouring resources into an institution with a patient success rate of zero.
Decision to Close
In late 1959, the City made public its decision to close Riverside Hospital. The ferry port on North Brother Island would close, and all hospital operations would cease, by June 1961. According to a former staffer, some thought the closure would be temporary. Many items from the school and the hospital were not packed away. Recent pictures from the island reveal a doctor’s coat on a hanger and a 1961 phonebook left open on a desk.
Since Riverside closed, redevelopment plans for North Brother Island have never veered far from the island’s original purpose. In 1965, plans were made (and then abandoned) to turn the grounds of Riverside Hospital into a “Center for Derelicts.” Later plans, which never came to fruition, included a maximum-security prison and a quarantined facility for AIDS patients. In the 1980s, the island was proposed as a haven for the city’s homeless population. A lawyer for the Legal Action Center for the Homeless exclaimed, “My God! Not only are they going to be segregated in poorhouses, they are going to be separated from the rest of the world.”
Today, Riverside Hospital’s buildings are crumbling and overgrown. A former teacher who recently visited the island with a special permit describes North Brother as a “jungle island” full of weeds and relics of a past the city has chosen to forget. Even the records of patients are lost, perhaps, as some believe, simply tossed in the trash.
Perhaps this is a fitting fate for the experiments at Riverside Hospital—people were sent there as refuse to be forgotten, and forgotten they were, as was the island itself. And the end of Riverside Hospital coincided with the deinstitutionalization movement, an end to the practice of treating the ill urban poor by hiding them out of sight to be unremembered. City officials came to realize the approach was expensive and cured nobody, and like the island, the practice was abandoned.