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Full text of "Annual report of the trustees of the Worcester State Hospital"

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953 ?Q.a3 



REPORT 
a AAX^,: WOR CESTER SmiEB HOSPimL CTta^olAajO ; 
Worcester l s Massachusetts 
Fiscal and Record Year Ending June 30, 1953 






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APR 12 

SiM£ HOUSE. SQS&QM 




53 

TSBM OF CGHEESTS 



Pag© 

Board of Trustees .<,..»»<» »«.. ...... 1 

Essid&svfc Soaff ■••••■«•««•••«••>•« X 

Chiofs of lursing Staff ..*««.!.. .*••.*» 2 

Eaads of Mn&nistrative Daparbssents .•...«•«» 3 

C'OBSHlS SET'S »»«eooe<soeooe»«»»»ao« .? 

Sij^riatenflsnt ! a Report (,«<.»..*•*«><»». o«o«.«. 

PtKTSOESSl 01lSStg©£3 cso.co.o.oaooosso.f'oooo 3.5 

F&fGa^nt Of PopOlatiOa ,,ee<»a»e*a»*a»ee IS 

Report of the Ollnical Director «,<,.•.«•«.»»<. 

©eaupatioaal Therapy Dspartxs=sat 000 *«oe«»ec. 3© 

Ddpsartiaont of feesiag eo<,o»ao.eo»»««.>«>e 41 

Roerestloa BopartJssat »4,. e o a ««o«.««eooo 45 

Religions Activities s , «eooo«e*«<.o, l .e« 50 
Social Service B@partss®at »<> „«><>«. <,...» o « o 

Madieal aad Surgical Department »<,••»•••«•> 57 

Physical Therapy Departisssat »»■•«•••••«<>'« 62 

X=»Ray Bspartisant (Ba .»««.^* >.».<.oc,.>oo o3 

B@Btal Departsssat ^ o^>«®a»«o»«<>e*«>' , •«« 64 

iiastsoratory »»©•••••••••••••••*•• o» 



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Rssaareh Ssrvio© • • « ..«■.<>•» • ••»«. «.« 71 

Psychology BepartEsat »•«»••«•«•«««»•• 74 

Publleatioa List soeneeaoesaae®*"** 

Moresstes* G^ild Guidance Clinic • »••••>•«<>• ^9 

Travelling School Clinic „«e.t>c. e »a«o«o» 97 

Steward's Bspsrtiaant • ••••••••*«••*•• 100 

Eagiasering Bepartissiit „ . *, „ «,« «c*. «<.*»» 105 

Maintenance Bepsrfesrsnt »» O0 «c. «»«.»»«• 109 

Matron 5 © Departisent «o.»e»o S a*»ees.<>ee» 113 

¥o®3S s s ftuKiliary .••••••••••••••••• 13.5 

Financial Report .« e . ••«»••>••••«•• 121 

Movsiaeat of Population Chart c«<,oe*«»«««* 124 



1. 



BOARD OP TRUSTEES 

Franklyn Jo Scola, Chairman* Worcester 

Mary Vo Campbell, Vioe-Chalrman» Worcester 

Daniel F» Murray,, Secretary, Mlllbury 

Anna Co Tataan, Worcester 

David Go Ljtuagbergs MoD«, Worcester 

Michael H« Selzo, Worcester 

Carl Go Nordgren, Worcester 

RESIDENT STAFF 

Bardwell Ho Flower, MoD«, Superintendent 

Richard Wo Kelson, MoDo, Assistant Superintendent 

David Rothschild, M.Do, Director of Clinical Psychiatry 

Bertha So Curtis, MoD«, Senior Physician 

Dean Mo Laird, MoDo, Senior Physician 

David Mo Moriarlty, MoDo, Senior Physician 

Jo Edward Lo Prunier, M.D«, Senior Physician 

Joel Ordaz Serratoa, MoDo, Senior Physician 

Pierre Bourdon, MoD», Assistant (Junior) Physician 

Emanuel Adams Daneman, MoDo, Assistant (Junior) Physician 

Urbano K* Guarin, MoDo, Assistant (Junior) Physician 

John Hraba, MoD«, Assistant (Junior) Physician 

Jacques Brlen, MoDo, Medical Interne (Psychiatric Resident) 

James Ao Haycox, MoDo, Medical Interne (Psychiatric Resident) 

George Chornesky, MeD», Psychiatric Resident 

Paul Eo Phoenix, MoDo, Psychiatric Resident 



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Dorothea R« Simmons, M»D«, Psychiatric Resident 
Brooks S« White, M*D«, Psychiatric Resident 
Miguel A. Mora, M»D», Psychiatric Resident 

Sir/ on Go Harootlan, D.M.D., Dentist 
Albert Eo Gardner, DoM.D., Dentist 

RESEARCH STAFF 
Elliot Ro Reiner * M*D», Senior Physician and Acting 

Director of Research 
Justin M* Hope, H«D*, Senior Psychiatrist (£ time) 
Lincoln LeBeaux, M»D«, Senior Physician f| tlsss) 
Bernard Cowitz, M»D« 9 Assistant Psychiatrist 
Leslie Phillips, M»A., Ph.D», Director of Psychological 

Research 
Marvin Waldman, M«A» 9 Head Psychologist 
Oscar Ao Parsons, M«A», Research Psychologist 

CHIEFS OF KURSIKG SmFF 
Kathleen C» Coutu, BoSo, MoEd«, R«JU, Principal of 

School of Cursing 
Florence Eaton, B<»S«, RoN«, Assistant Principal of 

School of Nursing 
Lillian Ra Kennedy , B*S«, R»N«, Assistant Principal of 

School of Nursing 
Eva Tobln, R*B«, Chief Hospital Supervisor, Male Ward 

Service, Main Hospital 



Mary 0. Santma&j R.N. a Chief Hospital Supervisor, Female 

Ward Service, Main Hospital 
Gertrude C, Walsh, H.N. f Chief Hospital Supervisor, Hale 

Ward Service, Summer Street Department 
Margaret M. Diamond, R.N., Chief Hospital Supervisor^ 

Female Ward Service, Summer Street Department 

HEADS OF ADMINISTRATIVE DEPARTMENTS 
Joseph P„ Koynahan, Steward 
Paul P. Foran, treasurer 

W&rren Q. Froetor, Chief Engineer, Main Hospital 
Newell A. Gordon e Chief Engineer,, Summer Street Department 
Anton Svenson, Maintenance Foreman 
S. James Mlstark, Head Farmer 
Lillian C» Carr 9 Matron 
Olive 0. Dorraan, Head Social Worker 
Evelina Elraadjian, Head Occupational Therapist 
Cr&e© L. LaFleur, Principal Clerk, Medical Record Office 

George L. Banay, Ph.D.,, Medical Librarian 

CONSULTANTS 

-irtrnnn^ni iTu ran i wmi i«i i wi m «ii»|i 

Franklyn P. Bousquet, M.D., Surgery 
Arthur 0. Brase&u, M.D. , Surgery 
Percy A. Brooke, M.B., Proctology 
Chester W„ Brown, M.D.,, Surgery 
John B. Butte, M.D., Surgery 






Digitized by the Internet Archive 

in 2010 with funding from 

University of Massachusetts Amherst 



http://www.archive.org/details/annualreportoftr144worc 



John ToBo Ganaody^ M D«„ Neurosurgery 

F» Benjamin Carr* MaD*,, Cardiology 

David Jo Cavan, M»D 0j3 Roentgenology 

Louis So Chase 9 MoDoj, Psychiatry 

George Fo Clancy,, M#D*, Obstetrics and Gynaecology 

George Eo Deering s Jr» fi M«D , Psychiatry 

Anthony DiStefanc,, M«Do, Surgery 

George A» Diac fi M<Do* Dermatology 

Thomas Dwyor*, MD* ? Psychiatry 

Lester Mo Felfcon* M D Oi( Geni to-Urinary Surgery 

Pranklyn So l^ltCj, MoDo, Pathology 

Bans Fulder* M«D©.» Internal Medicine 

Jacob Goldwynj, M«B &S Neurology 

Harry B* Goodspeed^, M*D», Otolaryngology 

IS&xsell Gould 9 MoDo s Anesthesiology 

Richard B n Gubber e D»Po, Podiatry 

Walter W* Jetter e MoD<,„ Pathology 

Robert Mo Johnson, M»Do & Anesthesiology 

Charles V« King* M^Do^ Orthopedics 

Sidney Kligerman^ M»Dop Psychiatry 

Lincoln Lebeauxj, M^D^ Neurology 

Sidney Levln„> M^Do* Psychiatry 

Donald Ko McCluskey p M«D Q ^ Obstetrics and Gynaecology 

Joel Mo Mellck* M«»D» e Obstetrics and Gynaecology 

Ervln Co Miller j, MoDo* Internal Medicine 

Arnold Ho Modell^ MoD e , Psychiatry 



Foscoe Wo Myer3, M«D<» t Ophthalmology 

John Wo C'lfeara, MoDo, Orthopedics 

Harry Rand* M,D 8< Psychiatry 

Edwin B« Seelye p U*V*, Surgery 

Oliver Bo Stansfleld, M»D» # Internal Medicine 

Julius J« Tegelberg, MoDo, Otolaryngology 

Anthony Vamvaa, M«D», Anesthesiology 

Arthur D, Ward, MoDo, Tuberculosis 

MoHo Yudell, MoDop Anesthesiology 



TRUSTEES " REPORT 

To His Excellency „ the Governor and to the Honorable Council: 

The Trustees of the Worcester State Hospital herewith sub- 
mit a report for the 121st flsoal year of the hospital , together 
with a report of the Superintendent, Bardwell H. Flower, M.D. , a 
report of the Treasurer, Paul P. Foran, and other information,, 

The officers of the Board during the early months of the 
flsoal year were Michael H. Selso, Chairman; Franklyn «J„ Soola, 

Vice-Chairman; Mary 7. Campbell, Secretary, On September 18 B 
1952 the following were eleoted and served throughout the re- 
mainder of the years Franklyn J. Scola, Chairman; Mary V. 
Campbell, Vice-chairman; Daniel Murray, Secretary. 

During the year the term of James Mattlmore expired and 
Carl C D Nordgren was appointed as his successor. 

The Board met in eight regular meetings and called one 
special meeting. In addition, Trustees were active in board 
committee functions. The hospital was frequently visited by 
various members of the Board, 

A matter of major concern to the Board of Trustees was suc- 
cessfully concluded. This had begun during the previous year 
when Mr. Joseph P. Kelly resigned as Institution Treasurer to 
accept appointment in the eentral office of the Department of 
Mental Health as Administrative Assistant to the Commissioner. 
After careful consideration of several candidates, the Board 
unanimously appointed Paul P. Foran, of Worcester, as Institu- 
tion Treasurer at its regular meeting on November 11, 1952. 



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Mr. Foran qualified and officially assumed his duties on Janu- 
ary 19, 1953. 

The Board maintained an active Interest and participation in 
the affairs of the Association of Massachusetts State Hospital 
Trustees. The chairman appointed Anna 0. Tatman as its represen- 
tative on the Executive Board of that organization » 

The members of the Board have been pleased by the further 
reduction in the number of patients in residence at the hospital 8 
while at the earn® time new admissions have not decreased, All 
members of the clinical services who contributed to this happy 
accomplishment are to be commended. 

The Board wishes to oall to your attention the fact that the 
buildings of the Main Hospital are old and not of first oiass con 
struotion° It is hoped that the need of renovation of these build- 
ing will be recognised and that successive buildings will be worked 
on eaoh year until at least all areas of patient habitation and 
congregation have been completed,, The Washburn Building, whioh 
has previously been renovated, has demonstrated the benefits to 
be derived in terms of patient comfort, Improved sanitation and 
reduction of fire hazards. In this connection the Board would 
stress the need of further alterations and additions necessary to 
meet reoognleed standards of public safety. Much has been done in 
this regard. Much is being done. Much remains to be done. These 
needs should have aetive attention, equal to that given to renova- 
tion of ward structures. 



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In conclusion^, the Board wishes to remark upon the 

loyalty and spirit of helpfulness which pervades the 
employee foroe at the hospital « 

Respectfully submitted,, 

Franklyn J, Scol&, Chairman 

Mary V. Campbell, Vice-Chairman Daniel P. Murray, Secretary 
David Go LJittigberg, M.D„ Anna 0, Tatman 

Carl Co Nordgren Michael H„ Selxo 



SUPERINTENDENTS REPORT 

To the Truateea of Worcester State Hospital: 

The f laoal year of 1953 has been a year of progreea and plana 
for the future. The following general thoughts should be kept In 
irind aa one reviews the appended reports of department and 
division heads. 

a Treatment , Eaeh ease admitted. Irrespective of age or 
duration of Illness , Is given a thorough ease work-up „ It la our 
policy to bring the newly admitted person to a staff meeting within 
the first three days In the hospital, where, under the leadership 
of the Clinical Director, a preliminary evaluation la carried out 
Including recommendations for special tests, studies or Investi- 
gations indicated; Immediate treatment procedures necessary and 
any other considerations pertinent to the case. Thus, at the 
outset our most experienced staff members plan with the residents 
the particular needa of the individual patient. After 18-24 day a 
in the hospital, each patient Is again brought to staff meeting 
for further evaluation, review of treatment if already instituted 
and decision regarding subsequent course of action. Thereafter, 
the patient is returned for staff review whenever decision is 
required on any important phase of the case, such as treatment 
modification, or granting of privileges (open ward residence, 
temporary or indefinite release from the hospital, etc.). 

During the year the hospital balanced the equation of ad- 
mission and separation of patients without the protection of a 



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waiting list. A total of 539 patients were discharged directly 
from the hospital and from visit and escape status. At the same 
time our pool of patients on visit to the community was main- 
tained essentially unchanged. At conclusion of the year our 
resident patient population was 86 less than at the beginning 
of the year 

B. Teaching . We have maintained teaching programs for 
each of the professional disciplines which contribute to our 
clinical therapeutic efforts. We have been a teaching center for 
4th year students of Tufts College Medical School and have carried 
on an active , well rounded training program for peyohiatrlo reel* 
dents (physicians )* which is approved by the American Board of 
Psychiatry and Neurology, Inc., for a maximum of three years 
training. We have furnished opportunities for training in clini- 
cal psychology to psychologists seeking advanced degrees in that 
field. Eight general hospital schools of nursing have been ac- 
tively affiliated throughout the year as a part of their teach- 
ing program for undergraduate nurses. We have conducted a train- 
ing program for student occupational therapists and for students 
from recognized schools of social work,, 

Our various teaching programs are based on the assumption 
that the majority of persons so trained will not enter the psy- 
chiatric field in the strict sense of the word, it is our hope 
that these efforts will contribute to the development of the 
general community resources for treatment s to the end that emo- 
tional and psychological disorders may be better evaluated and 



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more often and more adequately treated outside the mental hospital. 
It should not be overlooked,, however,, that these teaching pro- 
grume have been of definite and appreciated assistance to the 
hospital In recruitment of staff appointees in each of the 
professional fields. 

C° Research The gaps in knowledge and understanding of 
psyohlatrlo disorders are still many and large. For this reason 
a continuing program of researoh, which is psyehiatrlcally 
oriented* is essential . The research efforts at the hospital con- 
tinue to be focused principally upon schizophrenia, in which cate- 
gory is found the largest percentage of therapeutic failures and 
consequent long term hospitalisations. 

Our state paid positions are assigned here from the central 
Department of Mental Health payroll. They are in many instances 
assisted by house staff members and employees. The Worcester 
Foundation for Experimental Biology has actively collaborated 
and assisted in several projects 

D. Medical and Surgical Service . For many decades it has 
been a fundamental point in this hospital e program that the 
adequate treatment of the patient requires general medical facili- 
ties as well as psychiatric. The Medical and Surgical Service 
provides an important facet, essentially general practice in 
nature. Not only are obstetrical, general surgical, orthopedic 
and internal medicine needs mot, but also more obvious assist- 
anoe to psyohlatrlo goals is rendered by treatment of the acute 
toxic states* severe fulminating excitements, dehydration syn - 
dromes, and by opportunity for psychosurgery in selected oases . 



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The g&His of th© resident staff are augmented by a large number 
of qualified consultants, representing every specialty field,, 

E. 8 Continued Treatment " . This term is advisedly chosen 
to designate an Important concept of hospital function., It is 

selected to replace the tens "chronic custodial 9 and stems from 
th© philosophy that those ?<rh© do not improve sufficiently to 
leave the hospital should be regarded as our therapeutic failures 
rather than hopeless cases. Therefore, our attitude is that the 
long term patient group should he constantly reviewed from the 
standpoint of all therapeutic facilities currently available. 
While we have not been able to reconstitute the formal Continued 
Treatment Service of prewar daysj, this function has been given 
renewed emphasis during the current year, and it is planned to 
improve its effectiveness in the cosing year "by the addition 
of a social worker* 

F ° Physical Plant B Mention should be made cf matters which 
bear upon the physical implementation of the care and treatment 
program for our patients. The buildings of th© Main Hospital are 
old B dating back to the I8?0 5 s and ending In 1913, with the con- 
struction of Quimby Building, Our Summer Street Department was 
opened in 1833 as the original unit of the Massachusetts State 
Hospital system. In process no?? are plans for a new hospital 
building, to be constructed on the Main Hospital grounds g which 
Dflll permit the discontinuance of Summer Street Department as 
an active unit. At the Main Hospital, $sshbu:ra Building has "been 
completely renovated, including steel reinforced concrete floors, 



13. 



radiant heat and entirely reorganised "bathroom facilities «> It 
is expected that a similar renovation of Phillips Building will 
begin early in the fiscal year 195^. The importance of a con- 
tinuing program for the renovation of these old buildings cannot 
be emphasised too strongly. Hot only the need for improved living 
conditions for patients recommends it,, but also considerations of 
safety and fire hazard control as well. In anticipation of the 
new building on the main grounds , old needs become laore urgent „ 
The kitchen, cafeterias and ancillary servioes must be renovated, 
rearranged and better equipped if the dietary department is to 
adequately serve the integrated hospital which is to corns « The 
replacement of the two existing outmoded elevators and the addi- 
tion of two sore for Folsom and Thayer Buildings beecaes necessary, 
A proper central storehouse and additional day space in the form 
of an enclosed porch for Salisbury and Qulmby Buildings should 
not be delayed much longer. The construction of a new Male 
Bathing Suit® has dragged along throughout the year, fraught with 
many technical difficulties and delays* It is not yet completed* 
In pleasing contrast to this project, has been the rapidity with 
which work has progressed on the renovation of unused portions 
of the Farm House, which will make available five apartments fcr 
personnel «, 



14* 



It appears clearly evident that the old buildings of the 
Main Hospital must continue to serve for an indefinite period 

in the future „ It then becomes an obligation to integrate th 
in function with the nei* building which is being planned,, and to 
renovate them and to alter them so that they i*ili conform to 
recognised standards for public safety and provide more modern 

living conditions for the patient population housed within 
theia. 



15. 



PERSONNEL CHANGES 

Ralph A. Luce, M.D., Senior Physician, was granted Kilits 
Leave on January 10, 1953. Pasquale Buoniconto, Senior Physician, 
resigned January 31? 1953 to become Assistant Superintendent at 
the Walter E. Fernald State School. Luis Orlando Mederos, M.D. 
resigned June 18, 1953 to accept an appointment at St. Francis 
Hospital, Evanston, Illinois. 

Two Senior Physicians returned from Military Leave during the 
year; David M. Moriarity, M.D., on November 23, 1952 and D. Edward 
L. Prunier, M.D. on June 2, 1953« Dean M. Laird, M.D., was promoted 

* 

from Junior Physician to Senior Physician on January 25, 1953 • 

Jose M. Amador, M.D., Junior Physician, was granted Military 
Leave May 17» 1953* Werner Jaffe, M.D., Junior Physician, resigned 
January 31* 1953 to accept appointment at the King's Park State 
Hospital, New York. Bernard Cowitz, M.D., Junior Physician, was 
transferred to the Research Service January 1, 1953 • Rafael 
Alphonso, M„D., resigned December 31? 1952 to begin a residency at 
Worcester City Hospital, 

Richard M. Shannon, M.D., was appointed Junior Physician on 
February 23, 1953 and resigned April 3, 1953 . Urbano K. Guarin was 
appointed Junior Physician April I, 1953. Pierre B. Bourdon, M.D. 
was promoted from Psychiatric Resident to Junior Physician on 
January 1, 1953 • 

Psychiatric Residents appointed during the year were as follows: 
Jacques Brien, M.D., July 1, 1952; James A. Haycox, M.D,, July 9, 
1952; Brooks White, M.D., July 2, 1952; Paul E. Phoenix, M.D,, July 
2, 1952; George Chornesky, M.D., September 1, 1952; and Dorothea 



16 



Simmons, M.D., August 18, 1952. 

Altho we closed the fiscal year with one Senior vacancy and 
three Junior Physician vacancies, appointments to these positions 
had been consummated for early July, 1953* 

On the Research Service several withdrawals occurred. 
Nathan S. Kline, M.D. resigned as Research Director on October 18, 
1952. Yasuhiko Taketomo, M.D., Assistant Psychiatrist, resigned 
September 15, 1952. Edward H. Cranswiek, M.D., Senior Physician, 
resigned Cctober 25, 1952. Ash ton M, Tenney, Research Neuro- 
physiologist, resigned August 30, 1952. 

In ether areas of hospital function, important changes occurred 
On September 13, 1952, Far rand H. Van Dyck resigned as Chief Engi- 
neer at the Summer Street Department to become Chief Engineer at 
Westboro State Hospital. Newell A. Gordon was promoted to succeed 
him on September 15, 1952. On January 19, 1953 Mr. Paul P. Foran 
of Worcester assumed his duties as Treasurer, replacing Mr. Joseph 
P. Kelly who had resigned on January 13, 1952 to become Adminis- 
trative Assistant to the Commissioner in the Department of Mental 
Health. On December 9, 1952 William W. Stevens from the Metro- 
politan State Hospital was appointed Chef, succeeding in this 
capacity Fred Somerville who had retired in the previous year on 
March 31? 1952 after hO years of excellent service,, 
Retirements and Deaths: 

Elsie Haglund, Attendant Nurse, retired on August 9? 1952 
after 5 years of conscientious service. Ella MaeDonald, Charge 
Attendant, with over 20 years of kindly care to patients, re- 
tired December 13, 1952. On April 30, 1953, Joseph Quinn, Hospi- 
tal Supervisor Attendant, retired . He had rendered over 10 years 



17, 



of very conscientious service. On October 20, 1952, John C„ 
Anderson retired, and On April 30, 1953? Henry Gtistafson did like- 
vise. The former had been with the hospital 27 years j the latter 
21 years. Both were masons who became ill with pulmonary tube 
culosis. Sven Nilsscn, machinist, retired after nearly 20 years 
of service on June 30, 1953 • He will long be remembered for his 
skill. Fred Sprague, Third Class Power Plant Engineer, retired 
May 31? 1953 5 after 19 years of dependable duty. On September 30, 
1952, Anton Swenson, Maintenance Foreman, retired at conclusion 
of m-0 years of service which began September 30, 1912. Ke was 
temporarily re-employed in the same capacity on an emergency basis* 
On May 8, 1953? Dorothy A. Burnett, Junior Clerk and Stenographer, 
retired after many years of work here and at Gardner State Hospi- 
tal. 

Four employees died during the year. Hazel MacGeoch, Matron 
in Hale Nurses' Home, on March 3, 1953? 18 years of service 5 
Laura R. Pugh, Dining Boom Attendant, November 17? 1952, 7 years 
of service 1 Frank Dixon, Attendant Nurse, February 20, 1953? near- 
ly 6 years of service % James Taylor, Charge Attendant, February 
26, 1953? nearly k years of service. Each was a reliable and 
valued employee. 
Emplo yment : 

During the year the hospital has experienced relatively full 
employment. Out of a total permanent quota of 683 positions we 
have carried an average of 30 vacancies 0+,h%). The principal 
number of vacancies occurred in Ward Service positions (average 20, 
or 2.9$). Head nurses were most difficult to obtain. In this 
category we carried an average of 8 75 positions vacant at all times. 



MOVEMENT OF gOFUXA lXON 

During the year ending June 30 5 1955, Worcester State 
Hospital admitted 864 patients, 438 men and 426 wesson* Of these* 
629 (72oS^) entered a recognized mental hospital for the first 
time a A total of 209 (24 •!$} were classed as readmissions* having 
previously ©sperienced psychiatric hospitalization* Twenty-six 
(3»1^3 were received by transfer,, coming directly by Commissioner's 
order from residence in another psychiatric hospital within the 
Commonwealth* 

Separations during the same period totaled 939 {480 men and 
459 women}* The breakdown of this figure Is Informative* Two 
hundred thirty-one (161 men and 70 women) were discharged directly 
from hospital residence* Thro© hundred eight (115 men and 193 
women) were discharged from visit or escape status* Thus there 
was a total of 539 (276 men and 263 women) who were completely 
discharged from hospital supervision* The remainder of the 
separations is made up of transfers and deaths o A total of 114 
(53 men and 56 women) were discharged for transfer to other 
mental hospitals while £86 (146 men and 140 women) died« Of 
this latter total, three died while on visit in the community* It 
ia worthy of note that the transfer total Is abnormally high® 
Shis Is occasioned by the fact that during the year 76 patients 
(42 men and 34 women) were transferred to the new regional 
Tuberculosis Unit at Weatboro Stat® Hospital « She figure for 
total deaths (286) represents no significant change and Is in 
line with previous experience* Further comment on this may be 



19c 



found In the section of tills report relating to the Medical and 
Surgical Service • 

In final analysis, a hospital's function is summarized by a 
simple equation* It's bed capacity represents a reservoir* Into 
which each year is poured its admission rate and from which is 
drawn off its total separations c Applying this concept to the 
Movement of Population statistics, it is noted that the hospital 
began the year with 2831 patients physically in residence 
(1, 316 men and 1,515 women) « It operated without waiting lists, 
receiving 864 admissions* It's separations totaled 939* a 
favorable balance of 75 over admissions, and at conclusion of the 
year, patients actually in residence were 2,745 (1,257 men and 
1,488 women) o To be fully realistic, adjustment should be made 
for the Westboro transfer of 76 » Such an adjustment reduces 
discharges by transfer to 38 and results in approximate equation 
of the admission-discharge ratio (864:863)* To round out this 
picture, it should be explained that we began the year with 47 
patients in Family Care aid 397 on visit or otherwise absents we 
ended the year with 54 in Family Care and 401 on visit* etc* !Ihe 
residual discharge by transfer figure of 38 Is composed principally 
of transfers to V«A» hospitals (14) and return to other hospitals 
of women who have been sent here for prenatal and obstetrical 
care* It Includes three non-residents who were deported to other 
states for further hospitalise tion* 

An effort was made to determine to which extent the hospital »s 
facilities were used by the various courts during the year« 



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Twenty-four Section 100 ooBanitmenta were received (persons under 
complaint or indictment) plus one Section 105 commitment (tinder 
sentence in a state operated penal institution) and five Section 104 
commi brents (under sentence in a county penal Institution) <, 
Section 100 commitments to tills hospital generally emanate from 
Superior Courts • Many persons under complaint in District Court 
are committed to the hospital but these cases are not readily 
identifiable in statistics* therefore, a brief review of discharges 
was made, since final dispositions were a matter of compiled 
recordo It was learned that sixteen Section 100 oases and one 
Section 104 case were discharged back to court* In additions 
36 cases (29 men and 7 women), who had not been admitted by so- 
called criminal commitment* were discharged to the custody of 
District Court officials » 

Because of the ever-increasing interest in gerontological 
matters,, there is appended herewith a chart which reveals that 
35<>9# of all first admissions were 65 years of age or older « 
Breakdown by sex discloses that the percentage for female first 
admissions (39»5#) somewhat exceeds that for males (35/0 » Like- 
wise our actual admissions, female, (120) exceeded the males (106) 
in this age rangco 



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21o 



FIRST ADMISSIONS 
WORCESTER STATE HOSPITAL 
-SEAR ENDING JUNE 30, 1953 



Age Group 






Bale 


Female 


Total 


65-69 
70*74 
75-79 
80-84 
85 and over 




29 
19 
22 
25 
11 


21 
30 
23 
24 
22 


50 
49 
45 
49 
33 


Total First Admissions 
65 Tears of age and 
older 


106 


120 


226 


Percentage 






35# 


39o3# 


35o9# 



■; 












■ 



22, 



I§£23l 2£ SS clinical director 

Psychiatric Activities 

The primary concerns of a state hospital for mental diseases 
should be adequate evaluation of Its patients and adequate care 
and treatment for them. The staff of psychiatric physicians is 
responsible for these functions. It must possess a thorough 
knowledge of modern psychiatry and modern methods of treatment 
ranging from the various forms of psychotherapy to the shock 
therapies o The physicians should be able to function as thera- 
pists themselves and also provide leadership for the therapeutic 
team work vhloh can be a highly effective feature of the psy- 
chiatric hospital. 

The success of the psychiatrists in accomplishing these 
aims will depend not only on the quality of their efforts but 
also on the quantity, that Is, on the number of physicians avail- 
able In this oonneotlon it is well known that there is an 
overall shortage of psychiatrists , and at the same time there 
has been in recent years a definite movement of psychiatrists 
away from hospital work into private practice. As a result of 
these trends,, many state hospitals have suffered from serious 
shortages of medical personnel. It was our opinion that these 
trends might be reversed , at least in part, by improving and 
expanding our teaching program, thereby attracting younger men 
for training and perhaps inducing some of them to remain in hos- 
pital work. To this end we have expended considerable effort in 
the past few years, and with some success Judging by the fact 



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23c 



that we have been able to keep our start pretty well at full 
strength. In this respect, the formation of the Psychiatric 
Training Faculty of Massachusetts and our affiliation with it 
have been of definite help to us 

Another consideration in the stress on improving our train- 
ing program is the opinion, shared by many others, that an aotive 
teaohlng program for physicians not only improves their work: but 
also has a beneficial spread to other employees throughout the 
hospital. Consequently , the Worcester State Hospital regards its 
training program for psychiatric residents as the nucleus for the 
efficient functioning of its clinical activities . 

Clinical Aof frvltlfff 22& **91Pm 2* fo?*ftPy 

Ward conferences . The clinical activities revolve around the 
psychiatric work-up of new admissions by the physicians , and dis- 
cussion of these oases at ward staff conferences which are held 
regularly on the major psychiatric services of the hospital. 
These conferences serve two purposes: 1) they bring the patient 
and his problems to the attention of the Clinical Director and the 
psyehiatrlo service staff, so that the beet thinking of the group 
can be utilised in dealing with each patient,, and 2) they are es- 
sentially teaohlng ward rounds, serving to supervise and direct 
the clinical work of the physicians. 

At these conferences, which are held four times weekly, twice 
on the acute male psychiatric service and twice on the acute female 
service, all new oases are reviewed briefly within a few days of 
admission. The problems that they present are discussed and the 
lines of investigation and therapy that should be followed are 



••• 

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i *. 






. 






-rt& 868.80 H* K»ii 

I 



24. 



suggested. These patients are seen again at the ward conferences 
approximately three to four weeks after their admission, at which 
time eaoh physician presents a summary of the history , physical 
findings and mental status of the patients who had been assigned 
to him. After discussion of the slgnifloant factors, decisions 
are made as to diagnosis, disposition and therapy. 

At the conclusion of these conferences , attention is given to 
other patients who may hare been in the hospital for some time and 
who come for consideration of changes of management or therapy, In 

some eases where good progress is reported, the patients may be 
given greater responsibilities within the hospital set-up or plans 
may be made for their return to the community. Other patients who 
are failing to make satisfactory progress may be brought up to dis- 
cuss and to make decisions on modifications of the treatment 
program. 

The foregoing conferences are attended by representatives of 
the Psychology, Social Service , Occupational Therapy and Nursing 
Departments, and a free exchange of views is encouraged. 

In order to convey an impression of the day to day activities 
occurring in the foregoing conferences, it may be useful to present 
the following figures, which represent the average number of pa- 
tients seen per month during the year July 1, 1952 to June JO 9 
1953 for certain specif ic purposes at these ward conferences § 



- 
I 

[ 

■ 

■ ■ . 



. 



25o 



New patients 73 
Patients for diagnosis, disposition and therapy 68 
Special evaluation for: 

Visits llfc 

Open ward plaoeaent 46 

Consideration for Electric Shock Therapy 25 

Consideration for Insulin Shook Therapy 3 
Consideration for lohotoray 
Family Care 



i 



General staff conferences . Clinical conferences of from one 
to one and a half hours duration are held twice weekly, conducted 
by the Clinical Director and attended by all members of the psy- 
chiatric staff and hy representatives of the ancillary services 
of the hospital. Each conference is devoted to detailed discus- 
sion of an individual case presented hy a member of the psychiatric 
staff. Cases are selected which display problems of special in- 
terest from psychodynamiCs psychopathologi©^ therapeutic or diag- 
nostic angles., 

Program of therapy «, The hospital utilizes all accepted 
methods of treatment. It stresses individual consideration of the 
needs of the patient with the following types of therapy in minds 

1. Individual pgy oho therapy. Is considered the treatment of 
choice in many cases. The type and intensity will depend on the 
olinioal indications in each case,, with due regard for the work 
load of the physicians, and the need for close supervision of the 
psychotherapeutic activities of the younger physicians. This 
supervision is provided by regularly scheduled supervisory sessions 
by senior members of the staff and teaching consultants. An idea 
of the extent of this type of treatment may be given by figures 
which indicate that 43 patients were seen for a total of 334 



26o 



psychotherapeutic sessions (usually of about one hour u s duration 
each) on an average during eaeh month of the current year 

2. group psychotherapy is being used to an increasing ex- 
tent , though still on a rather modest scale. The figures on an 
average per month are as follows*. 

Number of groups 6 

Number of patients 51 

Kuraber of sessions 48 
Some of the groups consisted of patients who were already 
grouped together on the basis that they were receiving insulin 
shock therapy. Others were formed on the basis of oertain common 
problems, for example, a group of adolescent, delinquent girls, 
another group of middle-aged to elderly patients. In general, the 
type of group therapy has been non-directive and dynamically 
oriented. As in individual psychotherapy, careful control of the 
work of the younger psychiatrists is necessary, and for thie pur= 
pose one of our teaohing consultants has been holding a two hour 
supervisory session weekly. 

3. The concept of the therapeutic team is kept in mind in 
helping to attain as complete rehabilitation of the patient as 
possible. All the facilities of the hospital, if properly util- 
ized, may contribute to a successful result. A central foctxs of 
this combined therapeutic effort is an active program of occupa- 
tional therapy in which the nursing services and the industrial 
departments of the hospital are closely integrated. The program 
emphasizes the beneficial value of work, if properly prescribed 



27. 



and adequately supervised, In the various hospital Industries 
which provide a relatively normal work environment and a broad 
range of graded activities. For the success of this program 
there must be close cooperation and a sharing of leadership be- 
tween the physicians and occupational therapists in the place- 
ment and day to day supervision of the patients. At the same 
time 8 craft work and recreational and group activities are not 
negleoted, and in selected cases there are opportunities for edu- 
cational guidance with correspondence courses of a general educa- 
tional or vocational nature. 

*• 7he Social Service Department plays an important role 
in the total therapeutic program by concentrating on planning 
for the return of the patients to the community and their social 
rehabilitation. 

5. Special forms of treatment along physical lines are pre* 
scribed for individual patients on the basis of sound clinical 
Judgment. These would include electric shock and insulin shock 
therapy D prefrontal lobotomy and chemotherapy for neurosyphilis, 
sodium amytal interviews, a vitamin regime for alcoholic psychosis 
or other special medical measures indicated for toxic or organic 
states. In this connection, eleotroencephalographic studies of 
selected patients has proved to be a useful diagnostic prooedure„ 
The shook therapies have been used freely, though not indiscrimi- 
nately, and there is no doubt that In our present state of psy 
chiatric knowledge they are worth while additions to our thera- 
peutic armamentarium . A few details of some of these commonly 
used therapies are presented In the following paragraphs. 



28. 



a » Electric shock therapy ., We hare oontinued to 
use the standard, form of convulsive treatment. It ie 
often the treatment of ohoiee in depressive reactions 
of all types and in manic states. However., it is still 
felt that eleetrlc shock therapy should not he given 
routinely, even in oases of depression (where it may be 
especially successful), since some of these oases will 
respond well* and with probably better long term results, 
to psychotherapy and more conservative measures. In 
schizophrenic conditions, electric shock therapy is often 
prescribed in acute and stormy cases , but here too each 
case should be considered individually. It may be given 
to other schisophrenic patients in whom a trial of psycho- 
therapy and occupational therapy has failed to produce 
good results. It Is also given to selected chronic schiso- 
phrenic patients In an attempt to improve their institu- 
tional adjustment. In such oases it is usually given on a 
maintenance basis, that is, beginning with one treatment 
per week and gradually extending the length of time be- 
tween treatments to two weeks or a month or even longer,. 
Worth while improvement is obtained In a considerable 
number of ohronio cases by this method. In the more acute 
cases the patients usually reoelve three treatments weekly 
for from 10 to 20 treatments „ the exact number depending 
on their progress, and towards the end of the course 
the treatments may be spread out to a weekly maintenance 
basis for a few weeks. The following are a few figures 
for the current years 



29o 



Electric Shook Therapy 

Male Female Total 
Average monthly number of patients 8? 66 153 
Average monthly number of treatments 368 kO? 775 

Total patients treated during year 173 189 362 

t>« Insulin coma and, subeoma therapy . Insulin eoaa 
therapy ie the treatment of ohoioe for a considerable num- 
ber of schisophrenic patients , especially for those patients 
under kO years of age with illnesses of relatively brief 
duration (perhaps up to on© or on© and a half year's length). 
It may b© combined with individual or group therapy, or it 
may be given after a trial of psychotherapy alone has proved 
unsuccessful. The treatments are given five mornings a week 
until up to *K> or 50 comas have been obtained. Since this 
form of treatment is a distinct stress to the whole 
organism., the patients must be in good physical condition 
and they must receive very close nursing and medical super- 
vision. Insulin subeoma therapy is used on a more limited 
scale, for borderline oases of tension or anxiety states.? 
including some of -She severer neurotic conditions requir- 
ing hospital treatment. It may also be often combined 
advantageously with psychotherapy. The figures for the 
current year are as follows: 

Insulin Coma Therapy 

Male Female Total 
Average monthly number of patients 9 9 18 
Average monthly number of treatments 122 133 255 
Total patients treated during year 31 32 63 



Male 


Female 


Total 


1.5 


1 


2.5 


19 


10 


29 


6 


13 


19 



30. 
Insulin Subcoraa Therapy 

Are rage monthly number of patients 
Average monthly number of treatments 
Total patients treated during year 

o. Prefro ntal lobptomv . We have continued to use 
prefrontal lobotoray in selected oases. It is regarded 
as a treatment of last re sort » to be advocated only 
after all other methods have been tried thoroughly and 
have failed It has been applied chiefly to chronio 
schizophrenic patients who continue to show overactive , 
aggressive and tense behavior. A total of 26 patients 
reoelved prefrontal lobotomy during th© course of the 
year. A modification of th© standard operation in the 
form of unilateral lobotomy is being tried in some 
cases 9 with the idea that this sore limited procedure 
may show less of th® unfavorable blunting effeots of 
the standard operation. It is too early to determine 
how effective unilateral lobotomy will prove to be. 
?aychoaom,atic Ottt~?atjent Clonic. sM geriatric. Cllnj^ 
As part of the overall treatment program, the hospital conducts 
a psychosomatic out-patient olinio at the Worcester Oith Hospital , 
It Is held twice weekly, on one afternoon and on one evening. As 
a supplement to this clinic., a geriatric clinic., under the direc- 
tion of Dr. Harry Freeman and the Clinical Director, has been 
established. It meets bi-weekly. During th© year under review, 



31a 



the number of patients was as follows % 

New Patients Total visits to clinic 
Psychosomatic clinic 77 1382 

Geriatrie clinio 3 95 

These out-patient clinics fulfill an Important community 
function^ since they are the only adult psychiatric clinics in 
the city of Worcester. They also serve the purpose of providing 
the residents with training and experience in out-patient psy- 
chiatry. The psychosomatic clinic alms to provide psychotherapy 
on a regularly scheduled weekly "basis for patients who are con- 
sidered suitable for such treatment. When residents are assigned 
to work in the clinic they are supervised by senior members of the 
staff who see eaoh resident individually at least one hour a week. 
Over-all supervision of the psychotherapeutic activities of th© 
clinic is provided by one of our teaching consultants B Dr. Sidney 
Kllgerman* who conducts a weekly two-hour conference for all par- 
ticipants in the clinic activities, as well as group supex'vlsory 
sessions for second and third year residents. 

Training Program . Many of the training activities have 
already been described in connection with the work with patients 
to which they are geared. Some general features and additional 
details may now be mentioned. The hospital is approved for the 
three years of residency training required by the American Board 
of Psychiatry and Neurology for qualification for certification 
as a Diplomats of that Board. The training for first year resi- 
dents is designed to provide basic and intensive experience in 



32. 



the field of the psychoses and the more serious psychiatric con- 
ditions requiring care or observation in a mental hospital . They 
devote most of their time to admitting new patients and perform- 
ing complete psychiatric work-up of assigned oases under the 
supervision of the Clinical Director and senior members of the 
staff. They take an active part, under supervision* in . 11 
forme of treatment „ including psychotherapy and the shook thera- 
pies „ and they may help in the teaching of student nurses and 
medical students. The second and third year residents are given 
increasing responsibilities and opportunities for more indepen- 
dent work in fche treatment and management of in-patients and 
out-patients $ under supervision, and they participate in the 
ollnical and administrative activities involved in ward and 
service management. 

The demands of modern psychiatric training have necessitated 
the increasing use of teaching consultants to supplement and ex- 
pand the teaching program. Many state hospitals „ including the 
Worcester State Hospital, do not have a sufficient number of 
regular staff members adequately trained in dynamically oriented 
psyohiatry to supply the needs of modern residency training. It 
is hoped that in the future we will be able tokttract to and 
keep on our regular staff sufficient well trained men to meet 
these needs. The list of our teaching consultants, most of whom 
are in the Boston psychoanalytic group, is as follows = 



fx 



Dr. Lout a 3c Chase 

Dr. Thomas Bwyer 

Dr. Sidney Kligerraan 

Dr. Lincoln Lebeaux 

Dr. Sidney Levin 

Dr. Arnold Modell 

Dr„ Harry Rand 

Systematic training in individual and group therapy is pro- 
Tided lay the teaching consultants , who conduct a series of regu- 
larly scheduled supervisory sessions. Residents are assigned to 
the different sessions in accordance vlth the level of skills and 
experience that they have reached. In addition to this, first 
year residents are supervised in their psychiatric work-up of 
their patients by weekly individual conferences with the Clinical 
Director or senior members of the staff. Also, a series of weekly 
orientation talks extending throughout the year is given to first 
year residents by various members of the staff , including the 
heads of the Psychology, Social Service, Occupational Therapy and 
Nursing Departments. The major portion of this series is devoted 
to discussion of psyohopathology, historical aspects of psychiatry, 
clinical syndromes and psychodynsmlos. 

Neurological conferences are held from four to six times 
monthly. They include systematic presentation of neuroanatomies 
neurophysiology and neuropathologlo data as well as clinical 
examination and discussion of selected neurologic oases. 

An orientation in child psychiatry is provided for all mem- 
bers of the staff by means of a monthly teaching conference con- 
ducted by Dr. J. Welnreb, the Director of the Worcester Youth 
Guidance Center, which provides out-patient services in child 



t art* ^df J5 

■ 

- 

i 

*»% 

! 



34 



psychiatry for the Worcester area. There may he opportunities 
for third year residents to do part-time work at this center, 

A Journal Club meets bi-weekly during the academic year 
and all members of the staff may participate in Its activities . 

Medical Students . The hospital is affiliated with the 
Tufts College Medical School, which assigns two fourth year 
students at a time continuously during the academic year for a 
four-week Internship at the hospital. Members of the psychiatric 
staff give a review course of talks to the medical students and 
supervise their clinical work. The following students interned 
at this hospital during the course of the year: David R. 
Bassett, Richard E. Barron, Arthur F. Blekf ord, Jr. , Ronald 6. 
Gzaja, Charles L. Erlekson, Andrew D. Guthrie, Jr., Alfred L. 
Burst, Jr., Bernard Loltman, Albert D. McCarthy, Lawrence M. 
MeCartln, Duncan L. MoCollester, Robert W. Monerieff , 
Walter C. Murray, Robert C. Sohoenfeld, Elliott T. Shlnn, 
William G„ Shull, Ivan T. Vasey, James A. Whelton. 

togffftTgft && T*rt»UofrnoiM* As in the past, this hospital 
reoognises the importance of research in psychiatry, and it en- 
oourages members of the staff to take part in research projects 
with others on the Research Service or to undertake projects of 
their own, within the limits of the time available and the 
soientlf io capacities of the individuals concerned, In this 
connection, the clinical services cooperate closely with the 



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Psychology Department, the Dementia Praecox Research unit of 
the Worcester 3tate Hospital and the Worcester Foundation for 
Experimental Biology. The Research Service holds seminars for 
the psyohiatrlo staff from time to time in order to keep them 
oriented on the research activities of the hospital. 

The following papers were published by members of the 
psychiatric staff during the course of the year; 

MS,, Mora (with J.R. Friedman and J. Golombh The hair 
whorl sign for handedness, Diseases of the Hervous System , 
2JX208-.216, (July) 1952. 

S.Lo Sands and D, Rothschild, Soelopsyohiatrle foundations 
for a theory of the reactions to aging, J. Nerv , and Mont. 
Diseases . 13,6x233-2^1, (Sept.) 1952 

J C Sabbath and R.A. Luce. Psychosis and bronchial 
asthma, Psychiatric Quarterly. 2|>s562-5?6, (Oot.) 1952 

E,A. Daneman. Carbon monoxide poisoning, Diseases eg 

ana fierjaas £x*£s&, Ifes39-fc8, (Feb. ) 1953* 

R.A. Luce and D„ Rothschild. The correlation of EEG and 
clinical observations In psychiatric patients orer 65, 
£. St SS£ffiSal2Er, lsl67»172 9 (April) 1953» 



■ 

-tAnctAnrt? 

■ 

■ 

ml** 



36, 



OCCUPATIONAL THERAPY DEPARTMENT 

Personnel 

During this period personnel consisted of Mrs. Evelina Elmad- 
jian, OTR, Head O.T., and Mrs. Marjorie E. Valdman, OTR, who re- 
signed on January 30, 1953. Mrs. Elsa Fine, O.T. Aide joined the 
staff on September 15, 1952, Mr. Robert lienoit, O.T. Aide on Octo- 
ber 20, 1952, Mr. Charles Estano, O.T. .aide on December 17, 1952, 
and Miss Margaret Plumley, OTR, on March 3, 1952. This personnel 
was still employed on June 30, 1953. 
Department SsJMev ^nd Program 

Our policy remains essentially as outlined in previous re- 
ports. The policy of the Industrial Therapy Placement Service 
with acute treatment patients is to place the patient in a reality 
testing situation, which is selected for him individually and 
changed according to this changing needs, and on this level is 
aimed at rehabilitation with the final goal of returning to a 
work situation in the community. With regard to continued treat- 
ment patients the program is aimed at maintaining the patient at 
as high a level of mental and physical function as possible, and 
to give Mm a normal day of work and social adjustment within the 
hospital. 

Patients are assigned to work in positions in the hospital 
industries by physician's prescription. Each employee who has 
one or more patients working with him is called an industrial 
therapist. Thus the industrial therapist is responsible for the 









. 












. 






: 



. ■ 





















37< 



mental and physical well~being and occupational treatment of the 
patient during the working period, as well as for the production 
of his department. The occupational therapist serves in lie a ion 
capacity between the physician and the industry. It is her res- 
ponsibility to place all patients personally , to instruct the in- 
dustrial therapist regarding treatment alms, to check continually 
on the patient" 8 adjustment and progress, and to report the re- 
sults of the treatment to the physician. For this purpose two 
industrial placement of floes are maintained, with a full time 
therapist in charge of each, in whioh the details of such a pro- 
gram are handled and records kept. In this manner a dally aver~ 
age of approximately 800 patients are occupied at the main hospi- 
tal in tasks graded to their mental and physical capacities. This 
figure is based on patients on psychiatric wards only, and does 
not lnolude patients on medical and geriatrics wards. 

The two Occupational Therapy Centers have continued the poli- 
cy of treating individual patients under the direct supervision of 
the physician. Patients are assigned to the centers immediately 
upon admission and are graduated from the Center Into Industrial 
Placement for treatment as outlined above. The average dally 
attendance in the centers is approximately 40 patients and one 
therapist is employed full time in each center. In addition to 
new admissions, electro- shook and post°*lobotomy patients are 
treated. Fine and manual arts are used as treatment media , and 
socialising events are held from time to tlme 



- 






- 

■ 
- 






3*. 



During the report period a Ceramics Shop was set up in con- 
junction with the Somen's Center. A kiln is available. This 
project was found very beneficial as an outlet for emotional and 
creative needs, and functioned daily, with two evening periods a 
week under supervision of an O.T. student and two volunteers. 

Also during this period three ward projects on the Male Ser- 
vice were organized by the O.T. Department and carried on under 
the direct supervision of ward personnel. Supplies, instruction 
and advice were furnished by this department, and approximately 
L, hours per week of O.T. personnel were devoted to these projects. 
Supplies were ordered and disbursed by the head O.T. 

This department has co-operated with the Women's Auxiliary 
of the hospital in their activities in behalf of the patients. 

O.T. staff members attend an average of three staff con- 
ferences per week for the purpose of reporting on the progress 
of patients in Industrial Therapy and centers. An average of 10 
personnel hours per week is devoted to this. It is felt to be a 
v-tlid contribution to diagnostic procedure and treatment plans for 
the patient. 
Student Tr.aiQJi.nK 

The department is a clinical training center for occupation- 
al therapy students. This year 11 students were in affiliation 
in three 4 month periods - 10 from Boston School of Occupational 
Therapy, and 1 from Richmond Professional Institute, College of 
William and Mary. The head O.T. devoted 2 hours lecture and in- 
struction to each group of student nurses affiliating at the 



- 

■ . ■ ; ■ . ■ • 

■ • 

! ' . , 

•'■: ! " 

- 

- • 
■ 






• 






39o 



hospital. T;.llcs were given by head O.T. to residents. 
Recreational anj. SocjaUzlns AgUvJUe? 

Ten monthly dancing prrties with music, decoration, entertain- 
ment and refreshments were held during the year. Attendance at 
these events was from 500 to 750 patients. A monthly soci'l event 
was held for a mixed group of new admission and treatment pstients - 
attendance approximately 60 patients. Two mixed group parties were 
held for geriatrics patients - attendance approximately 150 each. 
This department co-operated with the Women 1 s Auxiliary of the hos- 
pital in their activities in behalf of the patients. During the 
suaier the department co-operated with the Theological Se.iinar 
students in outside activities, tennis, etc., and a ward program 
of activities. 

An all day Memorial Day program was arranged, consisting of 
an appropriate memorial day service in the morning, and a concert 
and community sing in the afternoon. 

On the 4th of July a carnival was held. 

On Labor Day an all day progran was arranged. 
Seasonal Activities 

The purc'iase and handling of hospital gifts to each patient 
was done by this department, the supervision of which consumed a 
great deal of personnel time from the middle of November until 
after the New Year. Approximately 3500 items were packaged in- 
dividually and distributed to the wards. Sixteen hundred and 
forty (1640) pounds of candy was sorted and boxed and distributed. 



( 



■ 

- 






AOo 



A Christians party and Hew Year's ball were given for all patients 
able to attend. Decorations vers made and arranged throughout the 
hospital. Decorations uere also distributed to the wards. The 
staff participated in the annual carol service. 
HQSpU^l Mewsoajer 

During this year a newspaper was organized, called HEI.S PRESS, 
which is a tiierapeutic project directed by the department. It 
consists of a 5 page lay-out and has a circulation of 1000 copies. 
It has a patient editor and staff. 






■ . • ■ 



■ 






1 



n 

*./*•.* 



DEPARTMENT OF NURSING 
Organization 

This department has two major goals, Nursing care of patients, 
and Education. The Principal of the School of Nursing functions 
as a Superintendent of Nurses with supervisory responsibility for 
all phases of the department's activity. The Chief Hospital Super- 
visors serve as Assistants to the Superintendent of Nurses in Nurs- 
ing Administration and Service, thus providing for coordination 
and correlation throughout the department. The Assistant Princi- 
pals of the School of Nursing serve as Co-directors of Nursing 
Education, having direct charge of instruction of Affiliate Nurse 
Students. 

Administrative Conferences are held each week with the en- 
tire Supervisory group including the "Attendant Supervisors". 
In this Conference the activities of the week are outlined and 
Nursing Service problems are discussed. The Head Nurse group 
has two meetings each month. The first meeting is devoted to 
Administrative and Service problems, the second meeting centers 
around problems of teaching the student Nurses on the wards. The 
second monthly meeting of the Head Nurse group is concluded with 
a sociable coffee period (expenses borne by a 25 cent assessment 
for each member of the group.) In the individual services the 
Doctor in charge has regular meetings with the Supervisor, Head 
Nurse and Charge Attendants in a group to discuss the problems 
of patients and how each one can contribute the best to meet 
these individual needs. 



■ . 

■ . 

■ 

■ 

i . 



' 



! 



I 






i 



A2> 



Mwsilnfl 9sn1,ce 

This year we set aside ward Washburn 4 as a unit for the care 
and rehabilitation of our post-lobotomy patients. Regularly 
scheduled activities such as occupational therapy, play and recre- 
ational therapy, personal hygiene and grooming, have been given a 
new eiphasis by having these patients on a single ward unit. Stu- 
dent iJurses under the supervision of a graduate Nurse have been 
assigned to the unit and the patients respond well to their program. 

Our Hydro cafeteria has been remodeled at this time. During 
the remodeling a temporary cafeteria was set up on the Woodward 2 
porch. With the renovations completed, the Hydro cafeteria has 
become a very pleasant and cheerful spot where our more disturbed 
patients can dine in small groups with close supervision. 

Fros September to November the entire personnel of the hos- 
pital was given the standard Red Cross First Aid Course and each 
was granted a certificate. This was accomplished by teaching 3 
classes 5 days each week and 2 evening classes each week. These 
classes were taught by Nurses from the ward services who had taken 
the Instructors Course given by the Red Cross. Doctors Flower 
and Kelson helped by giving several hours each. 

In June when the Tornado disaster struck Worcester, members 
of our personnel, Nurses and Attendants, gave tine to helping 
in other area hospitals after completing a tour of duty here. 
Several of our Nurses worked at local hospitals on their day or 
nights off duty. Many of our people had to do extra duty here 
also to help make up for those who had been personally affected 



■ : ■ 

- 
- 

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- ■ • ■ 

. I 

- 

■ 

■ 






43. 



by the disaster and had to miss work as a consequence. 
Personnel 

During the year we had 107 appointments to positions; 110 
separations from the service of the hospital. We made 13 pro- 
motions and 3 transfers from one departma 

another. It is our policy in selecting personnel for the Nurs- 
ing Service to use the services of a Committee composed of the 2 
Chief Supervisors, the Attendant Instructor, and the Principal of 
the School of Nursing (Supt. of Nurses). 
Nurstag Eduction 

We receive Affiliating Students from the following hospitals: 

Burbank Hospital, Fitchburg 

Faulkner Hospital, Boston 

Hahnemann Hospital, Worcester 

Milford Hospital, Milford 

Mt. Auburn Hospital, Cambridge 

St. Vincents Hospital, Worcester 

Worcester City Hospital, Worcester 

Framingham Union Hospital, Framing ham 
We receive students in a staggered rotation system, a group 
reporting every 6 weeks for a period of 3 months. We average a 
total of 46 students at all times. Each Student spends her first 
week in classes (kno^n as a class block) . At the beginning of 
the second week she is introduced to the ward situation by spend- 
ing her mornings on the ward and her afternoons in classes. At 



■ 

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■ 

■ 8. 



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the end of her first 6 weeks she spends her entire day in the 
ward except for periodically scheduled classes. The Doctors 
and Nursing faculty, members from Psychology Department and 
Youth Guidance Center, all participate in the teaching program 
A total of 255 student Nurses were given instruction in Psychia- 
tric IJursing during this year. 

As an important part of the overall teaching program we 
appointed a full time Nurse to the task of teaching the Atten- 
dants. This instruction is centered about their duties on the 
job here at this hospital and does not provide for licensure as 
a Practical Attendant. We feel that a sound educational program 
with stress by example of the therapeutic attitudes is the best 
possible method of raising the standards of Nursing care. 

We were fortunate in having a graduate Student from i'lcGill 
University, .-lontreol, Alss Alberta Hornibrook, R.M., spend a month 
with us observing and studying Nursing Administration in Nursing 
Service. We had a graduate Student from Panama, dr. iiiguel Tejada, 
R.N., who spent 6 months with us taking the basic course in Psychi- 
atric Nursing. 

Because of the decrease in the number of packs and continu- 
ous tubs ordered by the Physicians, it was decided to close the 
female hydrotherapy unit and use it as a space for Insulin Therapy 
to be given. The hydrotherapy unit on the male side had previous- 
ly been closed. We are still equipped to give an occasional pnck 
or tub if the need is indicated, but find that the other therapies 
appear to be taking its place. 



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45 



RECREATION DEPARTMENt 

The Recreation Director feels the need of varied activities 
and entertainments in a mental hospital and has tried to plar, 
for many different types of individuals. For the socially 
ellned, dances are given in Sargent Hall, for those who are 
interested in games, Whist, Beano and other games are planned,, 
As everyone likes plenios and parties, weenie roasts and out- 
side picnics are given and ward parties are held. We have b#en 
extremely luoky to have the American Legion Auxiliary, the 
Veterans of Foreign Wars and Auxiliary, the National Mothers 
and the Worcester State Hospital Auxiliary give parties and 
danoes for our patients during the year. 

There are many patients in the hospital who are musical and 
plans are made so they may have practice periods and re- 
hearsals. For the men who are interested in sports, ball games 
are held, and we feel that our own Worcester State Hospital 
"Blue Gaps" team is "tops". In order to make this report brie? 
it will be summarised as follows* 

TVenty parties were given on wards and in various indus- 
tries where patients work At these parties, refreshments &re 
served, consisting of cheese cracker sandwiches , cookies, candy .s 
punch, ice cream and cigarettes. On many of the wards* pati**-.*>- 
will dance, on other wards games will he played with prises of 
candy oars or cigarettes. On the wards where older folks re- 
side, they seem to enjoy the music of the accordion played by 
the Recreation Director. 






■ . 
: . 






us. 



In the summer time picnics are held outdoors and on July 
Uth and Labor Day, weather permitting, games and carnival ac- 
tivities are held In the morning for all patients able to go 
outdoors. In the afternoon a dance Is held and patients may 
dance on the outdoor danoe space to orchestra music, 

Weenie roasts $ birthday parties for elderly people, danoe s 
for all holidays p a fashion show, lawn parties given for Jewish 
patients by a Jewish organisation, entertainments and dances 
given by student nurses for patients and band oonoerts given by 
the Norton Band, were all part of the pleasurable events of the 
year. 

Twenty Beano games were held in Sargent Hall and on wards 
for patients who enjoy the game. Prises of candy bars, cigar- 
ettes , writing paper, cookies, powder, playing cards, pipes and 
tobacco were given to the winners. 

Nine Whist parties were given for male and female patients 
in Sargent Hall. Cookies and coffee were served at these parties 
and prises were given to high and low score winners. 

On Memorial Day a program was held in Sargent Hall. Oar 
student nurses gave a chorus number and solos were given by 
patients An address was given by our chaplain. Even though 
this is a solemn oocasion many patients attended and liked the 
Service. 

Our Christmas Candlelight Service is a tradition and many 
patients have spoken of the beauty of the Service. This is given 
by the nursing staff and the students. 

Christmas carols were sung on male and female wards by pa- 
tient carolers who marched through the wards. All patients 



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enjoy this and many patients show their appreciation by encoring 
when the carolers leave the wardo 
Church Services 

PIT ty- three Protestant Services were held during the year 
at Worcester State Hospital and Summer Street Department* Organ 
music was played at Worcester State Hospital and piano music at 
Summer Street Department., At the Protestant Services 556 male 
and female patients joined in choir work and many enjoy singing 
solos and duetse 

Thirty-five Jewish Services were held at Worcester State 
Hospital o Organ music was played for the Services o 

Twelve Episcopal Services were held at Worcester State 
Hospital o 
Prac tice Periods 

One hundred fifty-four practice periods were allowed in 
studio for patients interested in piano, violin and guitar and 
voice o 
Rehearsals 

One hundred t^ent,/- three rehearsals with violinist? ladles 
choral group, student nurses for Candlelight Service* soloists 
and student nurse chorus for Memorial Day number » 
Music 

Choir numbers » duets and solos given at Protestant Church 
Services by members of patient choir,, every Sunday morning ° 

Violin and organ prelude and postlude solos given at 
Protestant Sunday Services twenty-one Sundays during the year* 
(Patient violinist) » 



ASo 



Record music played lot studio by patientao 

Piano music played in studio « 

Violin and accordion music played on wards for patients 
enjoyment o 

Violin and accordion music played on lawns when patients were 
out in afternoon* 

Records borrowed by student nurses for music on wards « 
Games 

One hundred sixty-four games of Hearts, Whist, Pachesi, War* 
Cribbage, Casino and Rummy with groups* 
Soft Ball Games 

Our soft ball team bad 51 games at home field with patient vs< 
employee teams » One game was at Grafton State Hospital with 
Grafton State Hospital team and two games were with Hood's Mlk Co 
vso Worcester State Hospital Blue Caps* 

In the miscellaneous activity field were requisitions for 
party supplies > planning with ward nurses and department employees 
for par ties > monthly reports made out, choir robes and surplices 
to Chapel for use at Protestant Services* plans made with 
Entertainment Chairman of various organisations for parties to 
be given in Sargent Hall for patients, thank you letters to 
organisations for parties given patients. Whist tallies made out 
for Whist parties, 36 pianos tuned by State Division of the Blind, 
interviews with the Occupational therapy Department, Chaplin, 
Doctors, Steward, inventoxy sad beano cards put in order for 
beano games* Two pianos donated to hospital a New Cross and 



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49o 



candlesticks given to Summer Street Department for Protestant 
Services • Cards , games and recreation equipment given to wards 
for patients use* Interview with school girl about Musical Therapy 
New amplifying system installed in Sargent Bail,, June 16 9 1953 * 
Chairs back in Sargent Ball after 19 dances given.. Male patient 
helpers* One patient assigned to department to assist Recreation 
Director. 
Radio 

From our centralized radio control room* music and news is 
sent to wards by rebroadcast of outside radio programs , local 
programs from studio given by patient talent and recordings from 
control room of radio department with patient assistant acting as 
"disc dockey tt » 

A new microphone was installed in the studio, June, 1953 o 

Radio programs were typed daily* 

Twenty** throe radio programs were given over Worcester State 
Hospital radio station by patient talent - piano recitals and 
violin recitals* 

Thirty-four replacements in radio speakers on wards, June, 1953.. 

New relay system was installed in radio department - 
Electric rectifier for relay system (paging) June, 1953* 

Radio music, record music, and news sent to wards, five days 
of week from 1:00 - 4:00 and from 6:00 - 9:00 P«M» 



- 

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i • 
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I A 






.. 












50, 



The hospital is served hy Chaplains representing each of 
the three major faiths, Catholic, Protostasit and Je^lsho 

The CoEralseion on Administration and Flneao© has estab- 
lished rates for remuneration of full time accredited ®h&p~ 
laina. The Oatholio chaplain has been appointed, "by the Bishop 
of the Worcester dl©«a©s® and sssrrog full time. The Protestant 
chaplain nas appointed 9 on a frail tia®. basis, fey the Superin- 
tendent after he bad been approved for such assignment hy the 
Committee on Institutional Ministry of the Massachusetts 
Coonell of Churches. Si® Jewish chaplain still serves usadar 
th® older authorisation of f isced rate p®r religious ssrvio© 
h®Xd„ The rea@oiii fer this is that no generally accepted, 
ageney for the accreditation of rabbis existed, The United 
RabMni© Chaplaincy Commission ha® been formed and r@ cog- 
nised as the ©artlfying body. Based on Jewish in-patient popu- 
lation, the GoBiHsisslon on Administration and Finance has ap~ 
proved one-third time for the Jewish chaplain at %h® hospital , 
Sine© tills will require considerable readjustment of Jewish 
chaplain 9 ® time allotment, appointment binder the new plan has 
not as yet been accomplished,, 

The senior chaplain from the standpoint of length of ser- 
vie© is B&bfei Savid Alp©rt, ©f Brockllae, who has occupied 
tale position for c^er tisenty years. H&bfei Alpert Is keenly 
interested In his work. He hag regularly conducted services 
each ■areek; he h&w, been of assistance in problem® which have 



51, 



arisen in the eases of individual patients and he has main- 
tained a close relationship with the families of patients. 
If, as seems lifc®ly e th© new pattern of chaplain function will 
require that Babtol Alpert devotes his time t© institutions in 
the Boston area, h© trill la© missed by many friends at 
Worcester. 

Hext in service seniority is Rev. John X, Smith 9 the 
Protestant Chaplain^ who lias been with us sine© 19^8. His pro« 
gram is principally eonposefi of few functions s 1.) Beiigleas 
Services, flies© are conducted each Sunday ,> both at th© Main 
Hospital and at Suismer Street Department. Special services are 
held on Christmas morning and daring Lent. A patients 5 ehoir 
presides special msaaio. 2.) Visitation of patient®. An ef- 
fort is made to see each newly admitted Protestant patient 
during th© first wees: of hospital stay. In many instances, 
this leads to subsequent interview* Contact is also made with 
the families of some patients "by sail ff "by telephone or by per- 
sonal visits. 3.5 Teaching and Training Activities, ^he 
Protestant 8haplain served as one of the faculty for a six 
we©& suiter school. of Clinical Pastoral f raining for clergy- 
men s sponsored "by th® Institute of Pastoral Oar®, of Boston „ 
Fifteen students participated t representing seven denominations, 
eight seminaries and three countries. Also during the year the 
hospital provided a seminar meeting for institutional chaplains 
within th© state. ^* ) Public Relations, lis® Protestant Chap- 
lain serves in th© Bep&rteent of Religion and Health ©f the 



■•-: • • ■ 

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51a 



Sreater Worcester Area Council of Churches; on the Board of 

Directors of th© Central Massachusetts League of Hurses; on 
th® Advisory Committee to the hospital "s School of Parsing, 
and on the Board of Directors of the Worcester Committee on 
Alcoholism. H® has given many talk® regarding the. hospital to 
church groups and ©oimunity organisations. 

The Oatholio Chaplain is Rev,, Henry F. Murphy, vhose ser- 
vice vith us began in April, 1952. He celebrates Mass for the 
Catholic patients at the Main Hospital and at Sumner Street De- 
partment on each Sunday, Holy Day and H First Friday." The 
attendance at Sunday Mass averages 350 at the Main Hospital and 
at Summer Street Department, about 150. Schedules for Con- 
fessions are posted before these services, and the chaplain is 
available in his office during the day to patients who may 
visit hira there. Likewise, he administers the "Last Sacra*. 
meats" to all who are in danger of death. For this service 
Father Murphy is available at all hours for immediate call. In 
his absenos a substitute priest is provided. Father Murphy 
offers a Mass of Requiem and reads the committal service for all 
Catholic patients interred in Hillside Cemetery, ©sraed by the 
hospital in Shrewsbury. 

Tim chaplain endeavors to see each nearly admitted patient 
who Is of Catholic faith. E@ spends a great deal of time on the 
wards and counsels many patients in his office. On Saturday and 
Sunday afternoons he is available in his office for interviews 
with relatives and friends of patients. 



. 



ANNUAL REPORT OF THE SOCIAL SERVICE DEPARTMENT 
For year ending June 30, 1953* 
Olive E. Dorraan 
Head Social Worker 

Several years ago, the Social Service Department was forced 
to face reality, and to make rather radical changes in its program 3 
With the number of admissions steadily increasing, a nd the depart- 
ment having only four social workers at the time to take all the 
histories in addition to many other duties, we were expected to 
perform, we developed a feeling of frustration* As a result of 
many conferences with the Psychiatric Staff, the Clinical Director 
and the Superintendent, it was agreed that we would do no medical 
social histories, (which on six to seven hundred admissions were 
so time consuming), but that we should devote our time to getting 
patients out of the hospital, and keeping them out* It was further 
agreed that all patients who were ready to leave the hospital by 
Discharge from Observation, by short or long visits, whould be re~ 
f erred to Social Service for plans to be made with and for them, a 
that all patients out on indefinite visit should be the responsi-;: \ 
of Social Service for supervision during the year's visit period. 
Therefore, the Junior Psychiatrists and the Residents take the h: ! 
tories on most of the admissions, except those who come in unc r 
ciai Court Commitment such as Section 100, and those patients 
n whose history there appears to be a need for an outside ii li- 
gation to be done, these are referred to Social Service,, Carefu 



53, 



prepared questionaires which are sent to the families of all pa- 
tients, upon admission, are often painstakingly made out by the 
relatives, and these serve quite well in many cases* 

Our first contact with patients is either on admission, if 
relatives accompany them, and seem confused over the proceedure 
etc., or within three days, when as a member of the therapeutic 
team, the Social Worker attends the new case conference on the 
admission ward. There any assistance needed from the Social Ser- 
vice Department is suggested by the Staff Psychiatrists. 

On the first visiting day after the patient's admission rel- 
atives are encouraged to come to the office, for there are two 
Social Workers on duty every day in the year. We plant in the 

minds of the relatives that before too long their patient may 

conditions 
be able to leave the hospital, and/in the home which may have con- 
tributed to the illness thus may be talked out early in the hosp- 
italization* Anxieties, hostilities, plus limitations which the 
relatives, as well as the patient must recognize and sometimes 
accept, and the sharing of time and knowledge by the Social Worker 
with the relatives, makes for better adjustment when the patient 
actually leaves the hospital* 

Many so-called "Personal Services" are done for the patient 
on admission, which will ease his anxiety over bits of business 
which his admission Interrupted* Clothes at the cleaners, bag- 
gage at the R.R. station lockers, a dental appointment, a car left 
on the street, insurance or income tax due, rings or a watch at a 
loan company, pets in the attic or cellar when a patient is brought 



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54* 



in, children to be cared for when the mother leaves them, are only 

a few of the services which, instead of being "errand girl" type 

of things, affords the Social Worker an opportunity of making a 

worthwhile contact with and for the patient. 

We have attended all staff meetings and have participated in 

all plans for the patient to leave, even if it be only for two 

hours on the grounds. In making plans for, and with patients, we 

know as far as possible, who will take him, what home conditions 

are, work plans, as well as church attendance and recreation. If 

the patient cannot go home, we make other placement plans, which 

are mutually agreeable to the family and the patient. We keep in 

touch with a patient after he leaves the hospital on visit for one 

•" year, and assist him in every possible way. This has paid off in 

lowered readmission rates* 

For the year ending June 30, 195**-, we have been able to assist 

the other departments to more than balance our admissions and sep~ 

am t ions. We had 11, 3l6 interviews, divided as follows* 

With patients in the hospital 5,0*f2 

With patients outside the hospital 812 

With relatives in the Social Service Office *f,022 

With relatives in their homes 310 

With Social Agencies 700 

With patients in the Psychosomatic Clinic 110 
With clergymen, lawyers, doctors, police 

officers and others 320 

Two of our workers left during the year, one to study in 

Europe, and the other .to take a position in her home town. One 

of these workers has been replaced. The Head Social Worker 

served on a committee to write and publish "A Manual for Family 

Care." Several speaking engagements have been filled, and a paper 



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55v 



on "Foster Home Placement for Mental Hospital Patients" was pre- 
sented before the State Conference of Social Work- Lectures have 
been given to the residents and the student nurses and group meet- 
ings have been held with attendants on the Male Service to acquaint 
them with the services the Social Worker had to offer patients, and 
how we could work together* 

Mr. Lawrence Etter has been with us for the student year of 
nine months. Because of lowered registration in the Schools of 
Social Work for the past two years, we had only one student this 
year, but we feel it worth v/hlle to train even one, since we have 
three students become staff members as they finished their train- 
ing period with us, and received their masters degrees in Psychiatric 
Social Work. Mr, Etter came to us from the Simmons College School of 
Social Work. 

Our Family Care Department had a total number of W7 patients in 
homes on July 1, 1952, and on June 30, 1953 » the number has increased 
to 5^o We investigated ten Family Care applications from people in- 
terested in taking patients and accpeted seven. Two of our homes 
were closed because of Illness in the caretaker's family and the 
ten patients moved from these homes were absorbed in other Family 
Care homes without the necessity of returning them to the hospital • 
Nine patients were placed on visit status during the year, who had 
previously been in Family Care. 

Among our aims and ambitions for the year ahead, are these: 
A. To carry cji £££££ therapy wJJ&s 

1 - The pregnant patients who come to us from our other 



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I 
























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56o 



State Hospitals for delivery, to allay their anxiety 
about having their babies born in a state hospital 
and their worry over the problem of possible heredi- 
tary factors. 

2 -Parents of young schizophrenic patients, that we nay 

better understand the setting in which the psychosis 
has developed as veil as interpreting to parents what 
this hospital can do for their children during hospit- 
alization and on release* 

3 -A small group cf discharged patients, that we may assist 

them in their adjustment outside the hospital, after 
other contacts with the hospital have ceased* 
h -The new patients, for orientation purposes* 

B. Tj> hftvp a larger rmmbar of Social Workers. 

If we had more workers, we believe that we could increase 
the number of patients released for community residence 
as more effectively assist them in making adequate ad- 
justment in community living* 



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57, 



MEDICAL AND SURGICAL DEPARTMENT 

The hospital continues to operate a distinct Medical and 
Surgical Unit consisting of five wards for men and five wards for 
women» These wards provide 174 beds for women and 145 beds for 
men, totaling 319» It is our basic policy that any patient 
requiring bed care shall be admitted to this Service Doe to the 
steady pressure of cases needing such care, the bed capacity has 
gradually been increased over tfce years « The present situation 
in this regard is illustrated by the following chart* 

MEDICAL AND SURGICAL HARDS 
BCD CAPACITY' 



Actual 



Thayer 1 (male) 
Thayer 2 (male) 
Thayer 5 (male) 
Thayer 4 (male) 
Quimby Annex (male) 

Total, male 

Folsom 1 (female) 
Folsom 2 (female) 
Folsom S (female) 
Folsom 4 (female) 
Woodward 3 (female) 
Total, female 

Grand Total, male and female 

Excess of beds over rated 
capacity 



DoHoBo 


Bed 


Rated 
Capacity 


Capacity 
6/30/53 


27 


30 


24 


25 


26 


34 


21 


26 


27 


30 


226 


145 


27 


35 


24 


33 


27 


27 


17 


26 


S7 


53 


132 


174 



257 



24fa 



319 



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5S. 



In general* the Medical and Surgical Department furnishes 
General Hospital services to our patient population* It's chief 
is a Senior Physician, assisted at present by too Junior Physicians 
and by active consultants from practically every specialty field,, 
In addition to the usual conditions requiring general hospital 
care (such as surgical cases, internal medical problems, ortho- 
pedic emergencies* prenatal and natal oases, etc*) this service 
furnishes therapeutic facilities for acute toxic states (notably 
delirium tremens), acute fulminating excitements with electrolyte 
Imbalance, hypohydration states secondary to Improper food and 
fluid Intake, etc* We are licensed to maintain 6 bassinets , 
and pregnant women from the majority of the state hospitals are 
referred here for delivery* 

During the year, 912 patients were admitted (501 men and 
411 women)* Discharges from the Service are detailed in the 
succeeding chart,. ?he totals for the "Not Improved" group are 
abnormally high by virtue of the fact that 42 men and 34 women 
suffering from active pulmonary tuberculosis were discharged for 
transfer to Westboro State Hospital * Ihe two wards thus vacated 
were cleaned and renovated and occupied by other patients who 
would benefit from closer medical attention* 



DISCHARGES, EXCLUSIVE OF DEATHS. 
MEDICAL AND SURGICAL SERVICE 
TEAR ENDING JUNE 30, 1954 



Recovered and Improved 
Not Improved 
For Study Only 
Stotol 



Hale 


Female 


Hbtal 


393 
59 
10 


229 
44 
22 


622 

103 

32 


402 


295 


757 



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59* 



There have been 283 deaths (144 men and 139 women) plus 
two men and one woman who died while on visit to the community 
The principal causes of death are summarised as follows? 

Cardiovascular 184 

Infectious Disease 6? 

Neoplastic Lesions 15 

Renal Disease 9 

Gastrointestinal Disorders 3 

Drowned 1 

Extensive Second and Third Degree Burns 1 

Insulin Coma 1 

Miscellaneous _5 

286 

One open-ward patient, resident at Hillside Annex, collapsed 
beside a water tub for livestock and fell in, drowning himself » 
One patient was severely burned in a bath tub when the mixer 
valve failed* One patient died of causes referable to Insulin 
coma therapy* 

The principal causes of death were cardiovascular in nature, 
as might be expected from an average age at time of death of 
72*3 years o The category heading* "infectious disease 11 , is 
largely made up of terminal bronchopneumonia but also includes 
deaths due to pulmonary tuberculosis o 

There were 80 autopsies performed representing 29#* Lacking 
a resident pathologist* these were done by a consultant pathologist* 

Twenty-five deaths were classified as medicolegal, juris- 
diction having been accepted by the Medical Examiner a 

Twenty-eight deceased patients were buried at state expense « 
Seven more were referred to medical schools for teaching purposes « 



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«.ti» are aedtr cfi# «&«rf a j&1 JEKKttutf " 
eti oXo.arcola'X •• ^jaei: 

i$?a9£> 1o etoftt it a 93a eg 1 na motfl betfoeqxe 3 ee 

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i»«anto^ , soq ft6iaQ<ert.tm I 
.;-■■- -«oo b Tjtf mtiob vim sfitfti&t j,;teX;goXorfc?JBc 

;« BeXIUiBBflXo stow arlrf»al> »vl^ 

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60 



Consultations 

Regular x-ray clinics were held once weekly (total 51) by 
David J. Cavan M*D» for interpretation and report on all x-ray 
plates » Be also did 8V flourosoopiea related to 0*1* Series 
examine tions • 

Dr« Roscoe W* Myers held 27 eye clinics, seeing a total of 
109 patients* He is available both Tor refraction and for patho- 
logical conditions of the eyes* 

Other consultants were called a total 109 times, exclusive 
of surgery, for a variety of problems arising within •our patient 
population* 

In addition, a consultant anesthetist was used on a total 
of 122 cases* 
Ma .lor Surgical Procedures 

There were 115 major surgical procedures* Of these, 25 
were prefrontal lobotomies, performed by Br* John T„ B* Carmody 
end 17 were uncomplicated vaginal deliveries carried out by the 
resident staff* The remaining surgical procedures included hip- 
nailing, open reduction of fracture, suprapubic cystotomy, hysterec- 
tomy, bowel resection, herniorrhapy and amputation of extremity* 

Seventeen babies, (11 males; six females) were born at the 
hospital* There was no infant or maternal death* 

There were 303 minor surgical procedures performed* These 
included incision and drainage, suturing of lacerations, closed 
reduction of fractures and application of casts, debridement of 
wounds, evulsion of detached nails, cauterizations, biopsies 



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61ci 



and massive wound dressings for ambulatory patients. In addition 
there were 140 removals or foreign objects and 99 lumbar puncture* 
with pressure readings* 

Five days per week* Monday through *Viday, en ambulatory 
patient's clinic is held for examination, and treatment if indi- 
cated, of a variety of conditions such as early localised Infection 
pre-E*S„T* and insulin checkup, follow-up of minor lacerations 
and fractures, etc* An approximate average of 15 patients per 
day are so seen., A total of 35, 614 dressings were done at this 
clinic and on the wards • Once weekly, a gynaecological clinic is 
held for new female patients « three hundred sixty-four were given 
such examinations in this clinic* At the hernia and rectal clinic » 
held once weekly, 285 males were examined* Significant patho- 
logical cases discovered at these clinics were subsequently seen 
by appropriate consultant specialists. 

One thousand eighty-four typhoid and paratyphoid innocul«ition» 
were given patients and employees* Small pox vaccina tione totaled 
494* Blood specimens for Binton Examination were taken in 848 
cases * Only 12 new cases of lues were discovered during the 
year; each of these received an intensive three-day course of 
penecillln therapy* 

A regular employees' clinic is conducted five days per week. 
Here are seen and treated the minor ailments which may be dealt 
with on an ambulatory basis and as an emergency measure.. Industrial 
injuries are examined at this clinic whenever possible, although 
in many instances t&ese cases are seen at irregular times* Bight 
hundred elghty~six employees were seen during the year.-. 



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esq JEtttfl &JfcO£&x^ «xwo*fr»Tgtf*$g 
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2 



PHYSICAL THERAPY DEPARTMENT 

Mrs. Florence Boucher served as Physical Therapist 

through the year. 

Classification of treatments and tests are: 

Ultraviolet, air cooled 101 

Eaklng **?1 

Passage 240 

Diathermy 9^0 

Kusele Reeducation 319 

Total Treatments and Tests 2,091 

Total Number of Patients Treated 317 

In November, 1952, a new eight-channel electroencephalo- 
graph was Installed in the operating room suite « Two hundred 
sixty-six tracings were taken,, 






>10 









63, 



X-RAY DEPARTMENT 

i 
Mrs.> Mary C« Ryder served as X-ray Technician* Re new 

equipment was added during the year<» A tabulation of the work 

of the department follows: 



Parts 



Patients 



Films; 



Abdomen 


50 


90 


Ankle 


71 


76 


Barium Enema 


9 


29 


Cervical Spine 


17 


42 


Chest 


845 


850 


Clavicle 


3 


6 


Coccyx 


2 


5 


Dorsal Spine 


123 


187 


Elbow 


23 


24 


Encephalogram 


1 


8 


Esophagus 


2 


9 


Foot 


57 


63 


Gall Bladder Series 


14 


64 


C«I« Series 


26 


161 


Hand 


123 


132 


Hip 


99 


237 


Jaw 


12 


30 


Knee 


50 


83 


Leg 


42 


42 


Lumbar Spine 


100 


179 


Mastoids 


2 


14 


Nose 


42 


81 


Pelvis 


102 


113 


Pelvimetry 


6 


12 


Ribs 


48 


124 


Shoulder 


69 


139 


Skull 


133 


388 


Sinuses 


10 


28 


Wrist 


82 


83 


Zygoma 


9 


21 


Others 


22 


81 


Fingerprints 


5 


13 sets 


•total 


2199 


-3S573 «//*/■ 



I 






























64. 



DEIiTAL DEPARTMENT 

Daily dental clinics in operative and surgical dentistry 
have reduced the incidence of caries and diseased teeth, in the 
hospital's patient population as indicated by the submitted year- 
ly report. 

During the Summer months, two dental student internes have 
been instructed in oral diagnosis, oral hygiene, and surgery, 
operative, prosthetic dentistry, and Dental roentgenology. Empha- 
sis has been made in correlating oral manifestations with possible 
systemic or mental disturbances. 

Since oral hygiene is an important health measure in an in- 
stitutional community, a weekly check of 25 c /° of the wards, or 
monthly 100^ cheek of the wards, has maintained the oral hygiene 
standard of our mental patients. 

Aii effort is made to examine every patient, edentulous or 
not, at least once a year to check on any defects or growths 
that may have occurred since the last examination. 

(See chart to follow) 



DENTAL DiiP_-Ra_.EMT 
(Summer Street Included) 






EXAMINATIONS: 



Number of Patients 

Number of Examinations 

Microscopic Examinations 
X-ray and Diagnosis _____ 



TOTAI 



_______ 



JM3. 



16S 



_!___- 



Q 



TREATMENTS: 



Extractions _________ 

Surgical Extractions 
Fillings 



Prophylaxis __ 

Repair of Dentures ___________ 

Dentures Constructed 

Dentures Numbered for Identification 
Ligatures Applied and Removed ________ 

Sutures Applied and Removed _._, 

Fracture Immobilized .. , 

Alveoectomy __ . . . __ 

Anesthesia _ 



Miscellaneous Treatment 

Excision of Hypertrophied Tissue 
Others 



Jacket Crovn 
TOTAL __ __ 



Case Records Dictated 
Case Records Taken 



TOTAL, 



_____ 



6 



__l 

_"" 
_i 



120 



231 



jo 



82 



2 



12. 



___4& 



6 



_j 



-j_59I6 /-^// > 



8_v3 



_____ 
1516 



GRAND TOTAL 



_______r^>^3 



66. 



Walter Lechovicz and David L. Young, both from Tufts College 
Dental School, finished their Summer intemeship on September 12, 
1952. 

Edward G. Zapski and William F. Brady began their interne- 
ships on June 8, 1953. 






LABORATORY REPORT 

The Laboratory has functioned under the immediate leadership 
of Fred Elmadjian, Phd. and Edwin Lain son. It's major research 
undertakings are detailed in the section of this report dealing 
with the Research Service. The total number of tests and deter- 
minations for the year totals 38., 384- The more important pro- 
cedures are detailed below. 

Animal Bioassays Total Res earch Medical 

Rabbits (Asheim Zondek 

Test) 15 ~ 1 14 

Rat Blood Pressure 25 ■ — 25 

Rats, operated (endocrine) 

1402 1402 — 

Rats^ Colon Assay 259 259 — — — — 

Rats, Uterine Assay 152 — 152 

Endocrine Procedures 

Guard Separation Procedure 

373 _ 373 

Basal Metabolic Rates — 56 — 56 

Ketosteroid Extractions- 208 — 208 

Digitonen Separation 

Procedure 92 • 92 

Oolorimetric Determinations 

2757 — 2757 

Hydrolysates 135 135 — 

Chromatography 46I — 461 

Autopsies • 26 — ■ 26 

His to pathology . Post 

Morte.q Sections, — ~ 27 — 27 

B lood rlorobology 

Hemoglobin 3362 2 ——-—3360 

Red Counts 2799 — 2 2797 

White Counts 3772 — S3 3689 

Differential 5298 — — 377 4921 

Shillirgram 666 639 27 

Eosinophil Count — 559 - — — 553 6 

Platelet Count 9 — — 9 



68c 



Blood Morphology (Continued) 

Total Researc h Medical. 

Reticulocyte Count — - 3 — 3 

bleeding Time 127 127 

Clotting Time 127 127 

Prothrombin Time 153 153 

Hematocrit 307 307 

Sedimentation Rate - 215 — 215 

Blood Typing 298 ■ - — — 298 

Rh Typing ~ 303 — 303 

Cross Matching — 80 ~.- Q 80 

Spinal Fluids 

Clorides 5 »- 5 

Protein 100 — 100 

Gold Sol 100 — 100 

Sugar > 5 — ■■ • 

Bacterjology 

Agglutinations — 157 — — 157 

Bacterial Counts 

(Milk; utensils)— 269 • 269 

Cultures 

Blood 33 — 33 

Fungi — 1 ■ 1 

Nose & throat - 64 — 64 

Stools — 496 — 496 

Spinal Fluids - 92 — — 92 

T. B. 26 ■ — — — — 26 

Others — 7 — 7 

Occult Blood — 28 28 

Ova & Parasites 15 — 15 

Smears 175 — — 175 

Smears for T.B. 396 — — — 396 

Concentrations 

for T.B. 147 147 

Tissue Chemistry 

Cholesterol ■ 93 — - 93 

Extractions for Assay 

— -630 — 630 



Blood Chemistry Tptal Research Hgdlsai 

Albumin 151 — --— — 151 

Amylase 33 38 

Ascorbic Acid 20 — 20 

Bilirubin 91 91 

Bromide 70 70 

Calcium 11 11 

Cephalin Flocculation 126 126 

C0 2 — 6 ■ — 6 

Cholesterol 1013 ~ 724- 239 

Globulin ■ 160 -~~ 160 

Icteric Index 131 131 

K.P.H. 3164'-—— 3164 

Phosphorus — 14- 6 

Phosphotase 14 Q 14 

Sugar — 1337 ■ 13 1324 

Thymol Turbidity — 49 : 49 

Total Protein 205 — — 205 

Urea — 36 36 

Uric Acid 55 — 8 47 

Drug , Presumptive 10 — — 10 

Extraction for Assay- 146 146 

Chloride 13 13 

Urines, Qualitative 

Routine 3699 — 7 3692 

Bile — 18 ■ 13 

Urobilin 6 ■ 6 

Urobilinogen ■■ 6 6 

Occult Blood 11 11 

Drug, Presumptive 5 — ■ — 5 

Sugar only 63 63 

Sodium — — 70 — 70 — 

Potassium 70 70 

Creatinine 185 — — 185 — 

Phosphates 151 — 151 ■ — 

PH — 7 7 

Uric Acid 254 — 254 — 

Extractions for Assay 41 — 41 *— ° 



70, 



PODIATRY 
During the year, the Consulting Podiatrist -was ill for a 
tlsie and finally resigned. Richard E. Gubber began Ms services 
in June 1953. A total of 94 Podiatry Clinics vere held. 






During the year there were several changes in the Service,, 
Nathan S. Kline 4 M 6 D. resigned as Director of Research on Octo- 
ber 18* 1952. E&imrd H. Oranawlekj, 35. D, , Senior Physician^ 
resigned October 25 ^ 1952. Xasuhiko TaketosaOp M D , Assistant; 
Psychiatrist resigned September 15, 1952» and Asfeton M. Tennej, 
M.A. a Bessareh Neurophysiologist resigned August 30, 1952 c 

Before the year eloeed a new Director of Research, Harry 
Freeman 8 M,B 0i , had been . selected but had not yet reported for 
duty. Bp„ Freeaan has had a previous long association with re- 
search activities here. We are confident that ha will provide 
sound leadership and isproved coordination of research 
activities. 

fh& y®ar 5 g activities plus plans for the future are oat- 
lined DSXOVp 

Projects of the psvehistrle deimrtBeBt 

1„ Dr» Bolner is working on the problem of psychotherapy 
of the pay ©hoses. Approaches to this nave developed partly fros 
observations on patient® during ingulin coma therapy vhsre con- 
sistent fantasy experiences are expressed. Observations of Him 

fantasy productions have led to a plan ©f study of "both the con- 
tent and formal ^sharacterigtlcs of dreams of psychctlsa. $he. 
disclosure and understanding of this saaterial requires intensive 
Sososrledga of the motional life of the patients under study each 
as results from long, continuous association tilth the patient* 
It Is further planned for resident physicians to collabo- 
rate in an intensive therapeutic study of a few patients for 



;■;.. 



the purpoee of working out these objectives as well as new 
therapeutic techniques » One lead that appears particularly 
promising is the use of dual or even several psychotherapists 
working separately with the patient out in a coordinated effort. 
Under tails proposed plan of collaborative work with other phy- 
sicians goals of objeetiveness and improved control would be 
accomplished. Progress , then, would have been made toward 
greater understanding of the psychotherapeutic problems of 
schizophrenia. 

A report is being prepared at the present time of the 
effect* if any, of the recent tornado disaster on out-patients 
who, in course of psy oho therapy, were directly involved in the 
tornado. 

In the last year Dr. Reiner has written sis papers on vari- 
ous phases of insulin therapy. 

2. Brs. Hope and Labeaus are continuing their studies of 
the two adrenaleetomised patients under conditions of various 
medications. To date the psychiatric status of these patients is 
not significantly changed. They have, however, contributed val- 
uable data in the field of adrenal regulation by varying the type 
and dosage of the medicaments, which Include Cemp, S. , Comp* F. , 
Comp. B and licorice extract. 

The possible therapeutic effect of adrenalectomy in schizo- 
phrenia cannot, however, be evaluated in terms of such patients 
as these. There are too many extraneous complications of ageing 
and chronic physical illness. 






. 









.:. 



The psychiatric effects of various steroids (Corap. S and F) 
and lioorie© extract have also been investigated on schizophrenia 
patients and normal subjects. Ho definite effects have been 
noted. 

They have also made a comparative analysis of the psychi 

atrlo rating scale on schizophrenic and arteriosclerotic sub- 
jects (30) to determine whether the same type of scale is applic- 
able to the older subjects <, 

Research don© outside of the Kejsearoji Service fcjr Jjha Hoj^iSal 
""T ersonneir " 

Since July, 1952 Bre. Daneman, Chomesky and Eayeox have 
been engaged in studies designed to throw some light on the rela- 
tionship of arteriosclerosis and psychosis, various drags have 
been used in an attempt to ameliorate the symptoms of the arterio- 
sclerotic patient, SSicotinie acid was initially used as a 
cerebral vasodilator &n& failed completely to produce any efaanget;. 
Recently carbon dioxide (10$) and cortisone (100 mg daily for 
k days) have been used. The criteria of response have h&&n im~ 
provement in memory and diminution in the slow waves commonly 
found In the EEG'e of older people. For controls they have tested 
20 elderly men at the Masonic Home in Charlton, snder similar con- 
ditions. The data are not as yet completely analyzed, but they 
have found a correlation of „9 between the frequency of the brain 
waves and memory function. In this program the Worcester Foun- 
dation for Experimental Biology participated, furnishing trans- 
portation of the normal control subjects, paying them a fee for 
participation in the studies , and supplying the cortisone . 



■ 'V a 



Report of the ]tMM2£iz£M, i^3£^SM§Sll 

Service Activities, , During the year the number ©f contacts 

Tilth patients and other® examined and studied fcy rasmhers ©f the 

department are presented in the following table: 



*r of Huaher of 

Hospital Patients,.. Procedures 

House patients S3 206 

11 31 



Extra Mural 

Court 2 & 

School Clinic 58 109 

1 2 



Roxgfil Saojeetg 

Normal controls 73 ^® 

Total tests and patients 228 * 
seen. 





Individual Therapy 

Grand total of procedures 

Daring the yesar 1952-1953* the Psychology Department under- 
tool: research studies in certain phases of the psyehopathology 
of eehisophrsnie patients* Although it is a *&Fell-lsnwn fact 
that the schisophrenic patient is inadequate in a wide variety 
of 'beharicrs fl interpretations of these inadequacies haw been 
ambiguous and conflicting,, This appears partly due to the fact 






that relatively little Is Smarm as to whether such reported in- 
adequacies are unique to the schizophrenic group or whether they 
nay also he characteristic of other sooially Inadequate groups . 
The effort spent in experimentation with schisophrenic groups 
in controlling for such factors as age, education, intellectual 
leTel a degree of cooperation, ete«, attest to the importance of 
this problem. One set of variables , however, has not received 
such careful attention in this regard.. This its the factor of 
the premorbid social inadequacy of the schisophrenic as contrasted 
to the social adequacy of the usual normal control populations 
employed o 

In reviewing clinical and case history studies of schizo- 
phrenics It has been noted that such individuals typically show 
low social attainment, e.g., they tend not to marry and show low 
occupational accomplishment. It would thus appear that the 
typical schisophrenic has been a chronic failure in his adapta- 
tion to society before the onset of psychosis. It was inferred, 
therefore, that many experimentally observed inadequacies of the 
schisophrenic could be associated with a failure of adaptation 
existing premorbid!? (as well as at the time of testing) rather 
than with the psychotic condition itself. If this were the case 
then the uncontrolled factor of social inadequacy would have far- 
reaching implications; the inadequacy of the schisophrenic 8 e 
performance under experimental conditions might be held in common 
with any Inadequately adaptive individual and might not be unique 
to the schisophrenic 






Such a hypothesis hae been subject to test within the past 
year p one method being by the technique of experimental stress « 
For experimental stress situations, the hypothesis would Imply 
that the presence of the psychosis Is Irrelevant to the observed 
Inadequacy of the schisophrenic under conditions of experimental 
stress. He performs inadequately because he is a member of a 
larger class of individuals who show poor adaptation* 

It should follow 9 therefore, that social attainment, 
(adequacy of performance in real life) is positively related to 
the ability to perform adequately under conditions of experi- 
mental stress. Accordingly, the hypothesis wag tested that in a 
normal population those individuals of higher social attainment 
(as measured by the Worcester Scale of 3oolal Attainment) would 
perform more adequately on psychomotor tasks under conditions of 
experimental stress than those individuals of lower social attain- 
ment. The hypothesis was confirmed under two different stress 
conditions. 

Theso results supported the formulation that social attain- 
ment is related to an ability to cope with stressful situations. 
This has permitted us to infer with greater assurance, from the 
characteristically low social attainment of th@ schiaophrenlc s 
that the observed inadequacy of the schisophrenic under experi- 
mental stress is associated with a chronic failure of adaptation 
already in existence in the premorbid period rather than with the 
psychosis itself . 

Further experimentation has been directed to the question of 
whether areas of inadequacy other than performance under 






eacpe risen fcal stress ar-e assooiatad with poor adaptation rather 
than with the schisophrenic oondition pper sj»* To this end, it 

was fourof. that in a group of normal subjects, social effectiveness 
was also related to scoring on a scale of maladjustment. Similar 
to the inference drawn from the experimental stress study, it was 
concluded that a high degree of maladjustment „ as measured toy the 
maladjustment scale , was not unique to schizophrenia bat rather 

characteristic of a broader class of inadequately adaptive in- 
dividuals { . of which the schizophrenic is a member,, This infer- 
ence was tested more directly by the comparison of maladjustment 
scores of a schizophrenic group to that of another inadequately 
adaptive, yet non-psychotic group a assaultive criminals « Ho sig~ 
nifloant difference was found in scoring on the maladjustment 
scale between these groups. 

Two major implications follow from the above findings* 

(1) there appears to be a general factor of adaptation to stress- 
ful situations that is reflected in both social adequacy and per- 
formance under conditions of diverse forms of experimental stress; 

(2) characteristics assigned to schisophrenics moy be attributed 
to a larger population of inadequate individuals s of which the 
schisophrenic population is a sub-group. 

The nature of this general factor of adaptation lias been in- 
vestigated with the framework of a developmental approach by the 
utilisation of certain measures of Rorschach performance vhich 
have been found to be developmental in nature. The goal has 
been to delineate those processes that are unique to the schiso- 
phrenic condition from those processes specific to other inade- 
quately adaptive behavioral types* 



78. 



A second amid i^elated approach to this goal has been an 
analysis within a patient population of the manner in which 
symptoms tend to cluster and the finding that there appears to 
be three modal syndrome groups. This is the first step in in- 
vestigating within a generally inadequate group (in this case 
psychopathologlcal groups) those processes associated with 
specific forms of symptom ohoic®. 

There are in press, or in the process of publication, about 
18 papers on this general topic. 
Projects at the laboratory 

lo Under Dr. Elraadjian. This work is under the auspices 
of the Worcester Foundation for Experimental Biology. It is a 
resumption of investigations in the field of the autonomic ner- 
vous system which hare previously indicated a deficient response 
in the schisophrenic patient. With further enlightenment in this 
field by the work on adreno-ecrtieal functions and the relation- 
ship between the pituitary-aAreno-oortieal axis and the adreno- 
medullary -hypothalamic system, further research studies are in 
order which may throw new light on this phase of autonomic 
reactivity. 

Br. ElmadJlan is perfecting techniques by which he can 
measure noradrenaline and adrenaline in the blood of humans. 
The test is of a bio»assay type* the plasma being extracted and 
titrated for its oontent of thece substances against rat colon or 
uterus. He is at present analysing the amounts of these sub- 
stances in rat adrenals and brains. Initially, he is investigat- 
ing the effects of hypophysectomy; of stress such as insulin.. 



■ 



9- 



cold or traum&j of th® administration of steroids to normal 
and hypophysectcmij&ed animals. 

Preliminary work has been going on in a few human normal 
subjects, arthritic subjects and schisophrenic patients. 

The projected program, when the techniques are perfected, is 
to study the levels of adrenaline and nor-adrenallne in normal, 
psychotic and neurotic subjects and to determine whether there 
are any differences in stress situations. 

Detailed studies have also been made of the two adrenaleo~ 
tomlsed patients, their course having been followed closely by 
determinations of sodium and potassium. Various medicaments 
have been used in maintaining these patients, Compounds B, F, B 
and licorice extract, singly or in combination. These studies 
have been valuable in contributing to our knowledge of adreno- 
cortical physiology o 

2. Under Kr. Lameon. This work is under the auspices of 
the Worcester State Hospital. Techniques are being studied on 
two fields of investigation: (1) ketosteroids in blood, and 
(2) the endrogeneous synthesis of cholesterol; (3) the Korea 
project. 

The output of 17-ketosteroide is a measure of adrenc-gonadal 
activity. The usual procedure at present is to measure It in the 
urine, a method which Involves a great deal of tiae and effort in 
collecting the urine and which also brings in a factor of delay in 
time between the output of urine in the kidney and its ultimate 
excretion through the urethra. Blood determinations would avoid 
both these factors. As a method of measurement it requires as yet 
a good deal of investigation but holds definite promise.* 



■ 



■ 

- 



■ 






80 , 



The study of cholesterol synthesis arose from the findings 
of Dr. Shwehk at the Foundation that blood synthesizes choles- 
terol from acetate. This study was done with isotope-tagged 
material. Studies are going on at the hospital as to what frsc 
tlon of the blood contains the cholesterol;, plasma, red cells or 
white cells . Separation of these components must be made under 

cold conditions because otherwise there is a rapid deteriora- 
tion of the material., particularly the white cells. It Is for 
this reason that a refrigerated material is needed. Eventually*, 
when the techniques have been perfected* studies on cholesterol 
synthesis will be made in various conditions, schizophrenia,, 
arteriosclerosis and others. 

In the research project in Korea, the relationship between 
battle stress and adrenocortical activity was under intensive 
study. One phase of this was under the supervision of Dr. 
Elmadjian. The urines are now feeing processed at the hospital 
laboratory and the ketosteroids are being measured. The results 
should give extensile information as to the effects of an actual 
and extreme stress and throw light upon cur data which have been 
derived from experimental stress situations only. 

Studies under consider atio n 

1. Cooperative project between the Worcester State Hospital 
and the Worcester Foundation for Experimental Biology. 
Objective 

Since schizophrenic patients are known to exhibit certain 
abnormalities in urinary steroid excretion and adrenal 















. 









responsiveness and in view of the fact that a new method has 
been developed for the quantitative analysis of the individual 
urinary 17-lcetosteroid8j and since by use of this new method an 
approximation can be made of the endogenously produced steroid 
hormones , it is suggested that a project be started to more olosely 
define the abnormalities in steroid metabolism that schizophrenic 
patients exhibit „ 
Procedure 

Two projects will be undertaken. One is designed to study 
the metabolism of specific exogenously administered steroids, and 
the second project will be concerned with the type of steroids 
produced by adrenal stimulation as well as their quantitative 
assessment as a result of ACTH treatment. 

We have previously studied the metabolism of specific types 
of steroid hormones such as A «»androstene&ione s adrenosterone 8 
17-hydro&yprog®gterone s 17-hydroxy-ll-desoxycortieosterone, corti- 
sone „ and hydrocortisone in rheumatoid arthritic patients, These 
studies have yielded definitive information as to the pathways of 
metabolism of these important adreno-oortieal steroids. We have 
learned the relationship between these adrenocortical hormones 
and their urinary metabolites from these in vivo metabolism studies „ 
We propose now to administer these compounds, which are known to 
be non-toxic, to schizophrenic patients and study the metabolism 
of these compounds as compared to what occurs in normal controls, 
The procedure would involve the oral administration of specific 

compounds over a 3-day period. The various analyses of the urine 
would be performed Just prior to, during, and after the hormone 
administration. 






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82« 



The second project would be concerned with the responsive- 
ness of the adrenal cortex of both schisophrenic and suitable 
normal control patients to two dosage levels of ACTH. These 
dosages would be first, a minimum effect Ire dose of ACTH re- 
quired to increase the 17-ketosteroid excretion in the urine, 
and second, a somewhat larger dose. By our newly developed 
methods we could study in detail the responsiveness of the 
adrenals which, in earlier work, has indicated that the adrenals 
of schisophrenic patients are relatively nonresponsive, as well 
as indicate the qualitative differences In hormonal production by 
varying doses of ACTH. This study would involve careful collec- 
tions of urine just prior to, during, and Just after ACTH ad- 
ministration. The dosage 8 of ACTH that we Intend to employ would 
be in the low range for human subjects. 

Anticipated results 

These studies have been designed to yield the maximum informa- 
tion concerning the details of steroid metabolism. It is quite 
possible that these studies will elucidate some of the primary 
differences that exist between schisophrenic and normal patients^ 

2. Noradrenaline and adrenaline studies in schisophrenic 
subjects under basal and stress conditions. The background for 

this study has already been described. 

3. Investigative studies with drugs. There are two drugs 
which hold promise of quieting excited states in patients: 






Oa 



(a) Rauwolfia serpentina - an anti-hypertensive substance 
which apparently diminishes autonomic activity. 

(b) Chloropromazine - a substance tested in Europe and re- 
cently described at the International Physiological Congress at 
Montreal (September, 1953), which potentiates the action of drugs 
which aot upon the autonomic and central nervous system. It 
diminishes excitement and is of value In the therapy of acute 
psychotic states. 

A third drug 3 lysergic acid, has been already studied. It 
has the property of producing acute echlaiophrenie-like states in 
normal subjects and of exaggerating the abnormal responses of 
apathetic patients, The particular aspect under consideration Is 
whether this drug, by reactivating the acute aspects of the psy- 
chosis, can, in combination with shock therapy s result in an 
Improvement in such patients who did not respond to shock therapy 
alone* 

k a Further studies of factors of social inadequacy as ra» 
latsd to stress reactivity as described In the work of the 
psychology department. It is hoped to verify this hypothesis 
more fully by studying eehisophrenic patients from groups with a 
higher economic level,, such as possibly McLean Hospital^ or from 

areas such as Sewtan or Wellegley, who are committed to state 
hospitals o 

5. Dr. Reiner 3 s project on psychotherapeutic studies done 
by several psychiatrists on the same patients. At the minimuss 
this will be of value as a training procedure,, 



6 Therapeutic studies in ageing. This project has to do with 
ageing, "but la a development of hormonal studies in schizophrenia. 
It is Itnown that the excretion of 17-&etosteroide is diminished in 
age, an indication of diminished metabolic activity. It is pro- 
poses, to treat a small group of normal old men (70 years plus) 
with a mixture of steroids by mouth, over a 6-8 month period, de- 
signed to raise the level of the excretory hormonal productivity 
to that of young individuals « Tests will he made of effects on 
blood chemistry, memory, psychological response to psychomotor 
stress situations* and muscular strength. If improvement re- 
sults, the techniques can be applied to our aged psychotic 
population who form so large a proportion of our hospital 
clientele. 

The Worcester Foundation for Experimental Biology will 
supply the major part of the personnel and costs „ The hospital 
will contribute some services in the way of psychological tests. 

Further attempts will be made to obtain a few schizophrenic 
patients with metastatic lesions to determine the effect of 
adrenalectomy upon the psychotic state. 



85= 



LIBRARY REPORT 

1» Medical Library 

The Medical Library la constantly expanding with an average 
yearly accession of 300 bound volumes of periodicals and 100 
medical monographs and textbooks purchased from current funds* 
Aleq w© receive donations from the Medical Library Association 
Exchange and from members of the staff » At the present ©very 
available shelfplace is used to the limit and many little-used 
periodicals as well as older books had to be moved to the base~ 
ment stockroom to accommodate the newly acquired material • After 
many years of struggle with the unbound periodicals, neglected 
during lite war years., we practically caught up with the bindings. 
It is done by the Industrial Department of the Northampton State 
Hospital, all in one color 8 and rather crudely, but at least we 
do not have to worry for losing many single issues as used to be 
the case previouslye With this great influx of bound periodicals 
the two basesnent stockrooms are very crowded also and we are glad 
to hear that ground is supposed to be broken soon for the new 
Clinical Building where the Medical Library will be conveniently 
located on the 1&ird floor* 

The Library continued its services to the staff and with a 
large number of students (especially affiliate nurses), good use 
is made of our facilities* Although our book fund is rather 
limited we try to keep up with the new reference material coming 
off the press in a flood tide* 






To show the scope of our varied activities^ the following 

statistics are quoted; 

Periodicals received regularly 120 

Hew books purchased 90 
Items received from Medical Library 

Association Exchange 39 

Periodicals bound 520 

Interllbrary loans received 111 

Interllbrary loans sent 47 

Circulation figures 978 
Number of volumes in the library 12,325 

2* General Library 

The wide variation in i&e education of our patient-body 
necessitates a careful selection of new books & In addition to 
books of current interest, a solid foundation ia "laid for & good 
permanent library* Biographies, the Glassies, poetry, plays, 
short stories j, humor, art - in short* a book for ©very taste is 
provided in the library for our readers* The yearly appropria- 
tion, drawn from the Canteen Pundg is not large but it is enough 
to purchase the most premising books » As in the Medical Library 
the Geaeral Library shelves are just as crowded,, although the 
wear and tear is much greater here* Additional shelf place in 
a new location would constitute a welcome change for this library 
also a 

The library continued to be under the charge of Mas SfeOurren 

who maintained the regular services, including the trips with the 

book truck to the closed wards* The library is well patronized 

by patients and saiployees* Statistics t 

Sew books added to the library 290 

fikgazines received regularly 42 

Technicals periodicals sent to ikm deparuaents 17 

Magazines sent to Summer Street Department 11 

Circulation 7,592 

Number of volumes in the library 2,952 






HTBLICATTQ*! LIST 
1952 - 1953 

NoSo Kline , Synopsis of E» Bleuler's Dementia praecax, International 
Univ. Pr«, N»Y«, 1952 

g»Sg Kline ,, Some hazards in group psycho therapy 5 International 
jrl o f. group Psycho ther o 2:11-115, 1952 

J»H» Friedman, Jo Golomb & N« Mora , The hair whorl sign for 
handedness, Dls a Bervs System,, 13: 208-216, 1952 

J«H« Blair , R»Co Sniff en* E.E» Cranawicky W» Jaffe & H.S» Kline * 
Tho question of hlstopathol. changes in the testes of 
schizophrenics, Jrl of Mental Science » 98:464-465, 1952 

A a B a Sheflen & W»W Jetter 3 Delayed pathologic ssanifestatlons of 
hypoglycemic coma e Jrl of ffeuropathol* & E&pev* neurology, 
11:317-323, 1952 

Sol* Sands & D* Rothschild s Sociopsychiatric foundations for a 
theory of the reactions to aging, Jrl of lferv a & lent o 
Disease ,, 116:233-241, 1952 

J»C* Sabbath & B»A» Luce , Psychosis and bronchial asthma, 
1 ~Psychia tr« Quarterly,, 26:562-576, 1952 

DaLo Gerard & L »G» Houston^ Family setting and the social ecology 
of schizophrenia, Psychiatry Quarterly, 27s 90-101, 1953 

NoS» Kline & al » a Patterns of biochemical organisation related 
to morphology, Amsr* Jrl o f Psychiatry ^ 1095605-611* 1953 

S a Aa Danemang Carbon monoxide poisoning, Diseases of the I?erv B 
^ ~System7 14:39-48, 1953 

EJfU Reiner & A»E« Sheflen , The vital signs of insulin ccma 

therapy * A statistical ©valuation, Jrl of Clin* & Eacper o 
Psychopa tholegy , 13:139-151, 1952 

DoL» Gerard & L » Phillips , Relation of social attainment to 
psychological and adreno- cortical reactions to stress. 
Archives of Xieurol* & Ps^ hiatrya 69:350-364, 1953 

E» Eoagland & Go Pincua* Study of adrenocortical, physiology in 
normal and schisophrenic men, Archives of p enrol* & 
Psychiatry ^ 69:470-485, 1953 



88. 



J» Welnreb s, Report or an experience in the application of dynamic 
psychiatry in education, Mental Hygiene „ 571233-295, 1953 

A<»E,> Sheflen & E g R» Reiner,, Sensitivity in insulin coma therapy, 
Jrl of Clln» & Eacpero Psychopathole*>y . 13:225-236, 1952 

La Phillips & J»Qo Smith Rorschach interpretation* Advanced 
technique* Grune & Stratton, 1UY*, 1955 

RoAa Luce & D a Rothschild s, The correlation of EEG and clinical 
observations in psychiatric patients over 6B S Jrl of 
Gerontology fi 8x167-172, 1953 

AoBe Sheflen, B»R» Reine r & B ? Ocwita , therapeutic response in 

insulin coma therapy* A study of vital signs and sensitivity 
Jrl of Clin* & Expert Psyehopathol * 14:57-67, 1953 

EsRo Reiner a Fantasies in insulin coma therapy* Some psychosomatic 
considerations with a case report, Jrl of Clin* & Beeper * 
Psychopa thology B 14:84-94, 1953 

Lo Phillips 8 Case history data and prognosis in schizophrenia, 
Jrl of $erv* & Mento Disease & 117:515-525, 1953 

Lo Phillips & Jo La FremO s Developmental theory applied to normal 
and psychopa thological perception, Jrl o f Personality 
22:464-474, 1954 ~~~ ** 



9 



£Vv 



WORCESTER CHILD GUIDANCE CLBTIC 

This clinic began In the early 1920* s as an integral part 
of the out-patient activity of the Worcester State Hospitalo It 
has over the years grown into a separate State Clinic, liberally 
aided by the Community Chest of the City of Worcester and known 
locally as the Youth Guidance Center.. It is located in downtown 
Worcester at 2 State Street* Ihe State funds allocated to the 
Clinic are administered by the Commissioner of the Department of 
Mental Health, Jack R* Ewalt, BUD, Ihe Community Chest funds 
are the responsibility of the Child Guidance Association of 
Worcester* of which Abbe© W* Bal&mo Is president* On the 
Association^ Executive Committee, the Superintendent of the 
Worcester State Hospital and the Chief of the Psychology Depart- 
ment serve, ©x officio* Thus the Commonwealth is represented 
in all phases of Clinic activity and a bond of professional 
relationship Is maintained with the hospital, 

There Is appended herewith a portion of the annual report 
of the Center *s Director, Joseph Weinreb, M»D. to the annual 
meeting of the Association* 

Report of fee Director 
1953 - 1953 

R X am happy to report that the Youth Guidance Center has 
continued Its growth and development in ©very direction during 
the past year* 

I would like to restate the main functions of the Clinic 



90, 



and report the accomplishments la each area during this year* 2hs 
functions of the Youth Guidance Center are classified as follows: 

1„ Diagnostic Service 

2* Consultation Service 

3» treatment Service 

4* Professional Training in Child Psychiatry 

a. Psychiatrists 
b* Psychologis ts 
Co Psychiatric Social Workers 

5« Contribution in training other professions in 
Mental Health 

a* Uurses 
bo Teachers 
c» Ministers 

6» Public Education in Mental Health 

7. Child Psychiatric Consultation to other agencies 

8» Child Psychiatric Consultation Services to schools 

9» Research in Child Psychiatry 

Kiere has been an increase in service in all of the first 
eight categories* 2her© has been a slight increase in the amount 
of diagnostic* and treatment services* We have been and are 
increasing consultation services as a matter of policy as this 
represents an opportunity for a broader base of service to a 
larger miaber of children in the community » This consultation 
service is becoming more active not only to th© public at large v 
but to other agencies and schools as well* 

Professional training has been increased in child psychiatry 
particularly when funds were made available to us by the National 
Institute for Mental Health for a fellowship In child psychiatry- 
We have also undertaken a program with fee Division of Cental 
Hygiene of the State Department of Mental Health in ^ich we are 



91. 



supervising and training personnel to staff new clinics to be and 
already established in neighboring coramunitles* 2his is a very 
important contribution to the welfare of our Coameawealth, and 
marks a turning point in the policy of the Commonwealth in placing 
more effort towards preserving mental health rather than building 
bigger hospitals* 

In the field of psychology the lack of funds for trainee 
stipends has hampered us in enticing interns in that field* We 
are* however, training two of our own and three other junior staff 
members in addition to our cooperation with the Department of 
Psychology of Clark University. 

At title present time we are training psychiatric Social Workers 
from Boston University, Boston College and Simmons College* The 
Supervisor of the Student Training Program has been appointed to the 
faculty of Boston Universityo 

We have continued our program of contributing to the training 
program for student nurses at the Worcester State Hospital and 
Bfemori&l Hospital as we have for the past four years* In addition 
we have placed with us for training a graduate nurse from the John 
Hopkins University School of Public Health* We are also parti- 
cipating in a small measure in the training program of the Worcester 
District Hursing Society* 

Our work with ministers this year consists primarily of the 
inclusion of five interested ministers in a group conducted by 
the director* 

There have "bsen 536 lectures, discussions and group meetings 
with public groups during this past year*. 



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92 • 



W© are pleased to report that increasing number of social 
agencies have found us to be useful to tham and we were consulted 
during this past year by the following agencies s Family Service 
Organization, Jewish Social Service Agency, Worcester District 
Nursing Society, Division of Child Guardianship, Massachusetts 
Society for Prevention of Cruelty to Children,, Children's Friend 
Society, Community Chest, Worcester Department of Public Welfare, 
Young Womens Christian Association, Bay State Society for Cripple! 
and Handicapped, Ine», and Cerebral Palsy Clinic 

We were again able to operate the School Consultation Service 
in cooperation with the Worcester State Hospital and will continue 
this very promising service insofar as we can the ensuing year* 

'ihe one area in which we have not done sufficiently is in 
the area of Research.. It is an accepted medical principle that 
every clinical facility has as one of its obligations tc help in 
the increase of medical knowledge through research* We have ample 
opportunity for research at our Center, but due to pressure of 
other work no time has been left for lt« We are badly in need of 
funds for additional personnel that can carry on such a program« 

In the past three years since we have been at 2 State Street* 
I have bragged about the ample housing available in our nice well- 
located quarters* I regret or maybe I should be happy to report 
that we have outgrown our space and are on the brink of using bath 
rooms for working space* Hhere are, unfortunately, no spare bath 
rooms in our present building c We should be looking further into 
the possibility of increasing our spaceo 












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The Youth Guidance Center has by now received every possible 
approval f.faat a Child Guidance Clinic can possibly receiver, Each 
and every one of them are hard earned* 

lo Membership in the American Association for Psychiatric 

Clinics for Children* 
2s Approval for training in child psychiatry by the 

American Board of Psychiatry and Neurology. 
3o Approval for training in child psychiatry by the 

SSassachusetts Faculty in Psychiatry* Ine* 
4o Approval for training in child psychiatry by tfae 

American Association for Psychiatric Clinics for 

Children » 
5« Approval for training In clinical psychology by the 

American Psychological Association* 
6 • Approval for fellowship In child psychiatry by 

National Institute for Mental Health of the U.S» 

Public Health Service* 
7« draining in Social Work by Boston University* 
8* Training in Social Work by Boston College- 
9o "Training in Social Work by Simmons Collegeo 
10o Training in Mental Health Nursing by John Hopkins 

University ° 

It might also interest you to know that each of the above 
organizations has and exercises their right to fully inspect our 
clinic and our work without reservation^ 

These honors are not empty ones, for they are of great 
importance in our work and moat important of all these inspections 
and approvals are the most effective means of checking up on the 
work of the staff of the Clinic* 1 



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DEPARTMENT OF SJEN'BAL HEALTH 
DIVISION OP MENTAL HYGIENE 
ANNUAL SERVICE REPORT 
Worcester Child Guidance Clinic 



la QliPlc Service 

No» of clinic sessions (£ day) 510 
No > of visits to clinic by children 5543 
Average no« of visits per session 11 

2« Case Load 

Carried over from previous year 340 

New cases accepted 245 

Reopened from previous years 23 
Total no<, of cases served 

5o Co-seo Closed and Condition on Closing 

Diagnostic service rendered 67 

Treatment given 53 

Unasslgned 40 
Total no. of cases closed 

4 C Cases Carried Over to Next Year 



No* of cases 
5* A ges of New Cases 
Ages 0X234^ 



508 



HKT/&C) 



'2W 



6 7 8 9 10 11 12 13 14 Others 



No* of 

Boys 8 8 1 5 3 6 14 11 21 20 10 15 12 11 12 13 



Ho» of 
Oirls 



3 3 2 3 3 10 4 



3 



6 



6 



. 



clntlO at 









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: 



I 









6o Sources of Referral of law Cases 



Children* s Agency 5S 
Clinic Staff 

Coamiunity Education X 

Court S 

Family Agency 1 

Former Client 

Friend or Relative 49 

Be&lth Agency & 

Physician go 

School 118 

Others 1 

7» Inter^ietys with or isSxyut Patients or Prospective Patients 

% Psychiatrist 1485 

By Psychologist 3B5S 

% Social Worker (Clinic* Ccasauaity Office) 2S10 
3y Occupational SSisraplst 
% Remedial Reading 'Sator 
By Sp$oeh Instructor 
By Others 

3 * Conference gdLtfe or gbgut Patients 

Within &gency (Consultation t^ith Staff) 235 

Outside Agency (Group Conference on Cae© or Prohleia) 100 



9« List of Clinic Personnel 




Position 

Joseph Welnreb* M*1>4 Xttreo-ten* 

Willis Ploo£, H*D* Psychiatrist 

Pa-eld Moriarty* M*l>* Psychiatrist 

Polly Bssrees© Social Worker 

Emily Faueetfc Social Worker 

Maj02?i© Eayden Social Worker 

Catherine Arlauskas Social Worker 

fitonroe . Oreea Social Worker 



Bearh&s©. WMzsllp Ph*X>* 

&lic© Sastentjauia Psychologist 

Lsmranc© Bskin Psychologist 

S tanley ISsuger Psyefeologis t 

IScaa Jacelsson Receptionist 

Spirma Pespas 3r B Cleric & Stenographs;? 

Hilda Bssry 32? 4 ftLesfe & Stenographer 

©ane^ietr© Cfeegory Eyp&st 

«T©an Eierstoad Typist 

Joan Scott Receptionist 



96. 



Staff In. Training Position 

Hose Segur Social Worker 

Roalyn Ashman Social Worker 

Daniel Lynch Social Worker 

Bertoert Strean Social Worker 

Genevieve Madison Social Worker 

Dorothy Collard Nurse in Training 



97« 



TRAVELING SCHOOL CLIEt'C 

The Worcester Traveling School Clinic composed of psychiatrist* 
psychologists, and social worker functioned for the year ending 
June 30, 1953, under the direction of Willis ELoof, M„D„ and the 
general supervision of Joseph Weinreo, MoDo Later in the year 
two additional psychiatrists were utilised* The personnel was 
supplied jointly be the Worcester State Hospital and the Worcester 
Youth Guidance Center*. 

Service was given to 16 towns in our area as listed in the 
following table: 

School Clinic Cases for Year Ending June 1953 

Town Total Huraber of Cases 

Berlin 3 

Boylston 14 

Charlton 3 

Clinton 2 

Bolden 94 

Jefferson 2 

Horthboro X 

Oacford 1 

Paxton 3 

Rutland 3 

Southbrldge 2 

Southboro x 

Speneer 13 

Sterling 1 

Webster 4 

West Brookfield X 

It was decided to concentrate our efforts in several given 
communities and to give emergency service where needed» This was 
made necessary because our staff could only devote two days a 
week to this particular work and the area to be covered was large » 



. 






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Our plan of procedure was as follows; Prior to going to a 
given community the superintendent of schools of tfaat area was 
contacted and a time set for an interview^ At this time the type 
of service which we could give and its limitations were fully 
discussed » The super in tendant in conjunction wish the teachers 
and school nurse then arranged a schedule of interviews for the 
period we were there* All cases were treated in the same manner 
as a diagnostic study is handled at the Worcester Youth Guidance 
Center, except that the teachers were usually consulted before 
any child was seen* The psychiatrist, and when necessary the 
psychologist, saw the child while the social worker usually saw 
the parents* When all information was obtained from these sources, 
the team then held a conference of its own during which time the 
evaluation and recommendations were discussed* There then 
followed a second conference with the teacher and key people in 
the school at which time information was given to them which we 
felt would have a positive effect on the over-all teacher-pupil 
problems* The emphasis was in a sense upon consultation to the 
school© However., when we felt that the problems were such that 
outside help was necessary the parents were again seen and were 
referred to other agencies* On occasion when it was felt that a 
second or 1&ird contact with a child would be therapeutic this 
was also arranged* 

Xn general the discussions with the teachers centered around 
the positive influence they could have on children with emotional 
problems and the ways in which this might be facilitated* In 



- 






99, 



this regard we c&n honestly say that we often jue&rned as much, 
if not more* than we taught* There waa also sorae emphasis placed 
upon the use of ancillary ccaaraunity resources such as the Boy 
Scouts, YoWoCoiUj Y^-McCiAsp camps „ etc Some of the dynamic 
aspects of learning problems were clarified and through our 
diagnostic study we were able to differentiate for them the truly 
mentally deficient from those latoo had the capacity to learn, but 
were greatly inhibited by their emotional problems * 

The direct help to the children waa usually effected through 
favorably inf licencing poor environmental situations,, by giving 
needed information (with the permission of the parents) and by 
correcting mislnformationo Some children were referred for 
psycho therapy* 

Finally and most Important of all, we hope that the schools 
came to look upon us, not as interferring^ critical "Know-it-alls" 
but as sincere interested friends* 






'She books jpco? the fiscal year 2,953 were closed in good order 
witfa low imrentoi»l«s and the appropriation balancee which were 
reverted were ©^eedingly sassXU A few Tears back the Catcptrcllsr's 
Beparteaent of £he Cesssx&nwealt&i iiss tailed a Badgefcary Control 
Systosa* OSiia system is adequate and to fanctleaing satlafac torily* 

Xteing the current year a systssa wa© devised in which all 
institutions within the department of Elantal Bsalth would sulsaifc 
requisitions covering 1&eir needs to the Purchasing Bureau 
periodically « Also, under the supervision of the Purchasing Bare&u, 
patttsnta* clothing was displaced for several days at: the State 
Souse » Prior to this display, institutions had noted their needs 
on questionnaires supplied by i&© Purchasing Bissau* Vendors 8i3b~ 
jaitt@d ffiorchsodise along the linos requested in this questionnaire* 
During the period this clothing was on display, Slotting Sapsspviaers* 
Hursing Supervisors, Stsfflwdat, Housekeepers, end other Interested 
personnel of the institution visited the Stat© Bouse and noted 
their choice on forms supplied by tno Ps^chaslng Bureau* Fmx»tem®n 
were ssade as reeegsraanded on these fortas* What appealed to msay 
•was that they saw the- actual clothing on display^ that the 
Purchasing Bsre&u was vitally interested in supplying the needs 
of the institution, and the price Was only one facta?, and not the 
das&natiag am in amking the choice « Shis mantae of pugcSiasiBg 
clothing.* together wii&i periodic requisitions^ wag a vast improve*- 
ment oyer the xaenner in which goods were jroeured previously* 

For a f tm years the Department of Sbntel Health has been 



, 



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101. 



experimenting with a Master Meixuo One could say that during this 
fiscal year this Master Menu had worked with extreme satisfaction* 
It is the consensus that this experiment gave greater variety of 
food,, to the patients, at a lower cos to Of course* the psycho- 
logical effect on the patients that the entire hospital staff was 
eating the seme food* cooked in the same manner as the patients 
should not he overlooked* Satisfactory recipes which are the 
basis of this Master Menu have been the means of improving the 
food* She Master Menu also has been the real basis of the budgetary 
request* In other words, the daily cost per eater was established,, 
and this cost projected to the number of eaters* and funds for 
the food account wars appropriated on this basis * It has now been 
definitely established that budgetary requests in the Clothing (06) * 
Furnishings (06)* Travel and Transportation (10), Repairs* Altera- 
tions and Additions (12) are based on formulae established by the 
Department* The funds received under this set-up have been 
adequate* In fact with proper control at the institution level* 
there should be adequate clothing and an adequate amount of all 
types of supplies* 

Since 1958* each report has discussed the Storeroom situation* 
This essential department's quarters are a series of basement roomsp 
which are entirely inadequate* end expensive to operate* She time 
allotted to control supplies is considerably greater than needed* 
if quarters were adequate* 

The Laundry during this current period has functioned very 
satisfactorily* The same may be said of the Dry Cleaning Plant* 



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Duping 1Mb etg3?©XEfr fiscal 3©as», t?e has© don© the dry ©leaning tor 
this institution* Grafton State aaspital e Wesfchor© Stats© Hospital, 
scsae dry ©leaning fop TSaafield State Hospital, and a consides'&'ble 
aiaoaat for Waiter B« F©3?»a2d Spools and Efr3.es Standia&» 

I& the mSxt Cafeteria we have a quota of nineteen (19} dining 
room attendants* tFnfortunately, we have espexi^aiced the aess© 
coalition this seas* as 2a preTions years* D«s?ing this eurreafc 
fiscal year., sSxtscaa (3.6) dinlEsg rocsx attendants fcessain&ted their 
services* ITils is a tswsaeafiotja tus%«<oqr@r» and it is extremaly 
difficult to fe?ala gersonael sender this conditions Xt is fait 
that the reason for this ton*-©*©* is that t&e salary is i&adeq.nafee, 
and the w$Vk rather hard and dlf fieult, and lastly* that the «ard 
attendants recei^r© a higher salary $&&& a dining roeaa attendant. 



• 



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• V. 

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103. 



FARM REPORT 

The operation of an Institution farm is a challenging under- 
taking with many real problems a Management of 400 - 500 aero a 
of land requires a great deal of skill end know-how* plus equip- 
ment and labor* The growing of vegetables demands many weeders 
and long hours of work. Our patients perform much of the manual 
labor, which is considered good therapy* However, baseball, 
athletics and special projects continue to drain the work forces <, 

The vegetable program fits in well with our other projeetso 
Crops should be rotated every three or four years* By turning 
under our forage crop sods and alternating with vege tables , we 
not only obtain higher yields but also maintain sound conservation 
practice « Rainfall is always a controlling factor in vegetable 
production and this year gave us below average rainfall during 
July and August* Some surplus vegetables were sold to other 
institutions 9 while surplus beans, cucumbers and tomatoes were 
sent to the Institution cannery « a total of 180,341 lbs* of farm 
products were canned,. 

The production of cattle forage requires good weather , equip- 
ment and labor* Quality forage is a must in the maintenance of 
good health and high production of our herd of 70 miiyin g cows 
and 50 replacement young stock* With the life expectancy of a 
cow approximately three lactations, it becomes worthwhile to 
work towards a wen-fed and healthy herdo This has been a good 
milk production year with the cows hitting a new high record of 
15500 lbso of milk per animal and a butterfat of 581 lbs* The 









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X04< 



real problem is to plan a program which keeps the cows calving out 
on the average of 12-14 months, thus Insuring an even flow of 
milk throughout the year* 

Growing hogs has been a profitable venture on this farm* 
Plenty of garbage, plus grain for the finishing stages, gives us 
about 50,000 lbs* of pork available for Institution consumption* 
Our sows have averaged 7-8 pigs per litter, nearly double the 
national average o 

Ihe orchard does its bit towards our institution diets o Al- 
though our 18-year old orchard is considered young, over 50,000 
lbs* of fruits were harvested* Weather again is a determining 
factor with heavy rainfalls early in the spring necessitating 
10*15 spray applications » Ihe crop this year was outstanding from 
a fancy viewpoint* We were presented a 90% fancy apple certificate 
from the Massachusetts Apple Grower Institute for qualifying under 
their strict rules » 

Maintaining the grounds requires constant supervisiono During 
the winter months, much sanding was done on roads and walks and 
considerable snow plowed to keep the roads open* Summer care of 
lawns and flower gardens is classified a major project* 

Six acres of usable land was carved out of the Hillside Pine 
Meadows swamp, and approximately the same acreage was sold to the 
DoPoWo to establish a building and storage yard* The main hospital 
avenue was re-surfaced with bituminous concrete type I, which ahov-ld 
make repairs unnecessary for a period of twenty years* Considerable 
tractor and manpower was provided for the new main hospital front 

parking area* Production statistics for the year 1952 

Milk 1056341 lbs* 

Pork 50650 lbs. 

Vegetables 646857 lbs» 

**uit 52248 lbs* 






• 



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105 . 



ENGINEER'S KEPARQMEHT 

Ac Main Hospital 

1* Personnel ? Warren Go Proctor served as Chief Power 
Plant Engineer throughout the year© Sven Wilsson, Machinist, 
retired after 20 years of service* 

2« Fuel Consumption 

Bituminous Coal 171*5 tons 

Anthracite Coal 80»25 tons 

Bunker C Oil 1,310*945 gals* 

Ko« 2 Fuel OH 47,306 gals 



Electric Power Generator 1,544,900 E«W«H« 
Water Used 18,500,000 ego 

5o Electrical Works o The electricians serviced all 
electrical apparatus throughout the hospital regularly* Over 250 
motors were oiled and cleaned* A new electric motor (10 B*P*) 
and hayloading apparatus were installed at the Bay Barn* They 
removed old light fixtures from several offices and a few 
selected wards and replaced them with fluorescent lights, sub- 
stantially reducing the amount of electric current used and 
Improving illumination* AH fire alarm batteries were checked 
weekly and fire alarm gongs twice monthly* 

4» Steamflttera and Plumbers* The old steam return lias 
between the Avenue Cottages and Bale Nurses Borne was renewed* 
About 120 feet of old water pipe beneath Quimby building was re- 
placed with copper tubing* All sprinkler systems were inspected 
twice weekly o Compressors and refrigeration units were inspected 
twice weekly and serviced when necessary* Many items of broken 
machinery and piping were welded* Pipe tables and stands were 



3 



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i-: ... 



106, 



made for ward use© A new boiler was installed at Prospect Cottage* 

Cast Iron soil pipe under the Tin Room in Kitchen was 
replaced and vented« A new dental chair was installed and the 
old dental chair relocated* Sinks were put in at Wheeler Cottage 
and in two apartments at the Farm Bouse* The water main beneath 
the Farm House was replaced* The Hydro Cafeteria dishwasher was 
overhauled and renovated* 

Emergency service was maintained for plugged toilets, wash 
bowls 9 floor drains , etc* Two areas of sewer line were freed of 
obstructions* 

5° Machinist * The machinist serviced machinery throughout 
the Main Hospital including sewing room, mending room, laundry, 
kitchen, bakery, and three elevators* Likewise , oil burners were 
maintained In working order* 

€ » Bagtoe and Boiler Room Repairs* The Ames Engine was 
overhauled and repaired* Number 2 and number S boiler feed pumps 
were overhauled as was number 1 vacuum pumpa Four boilers in the 
lain power plant, one boiler at the Farm House, one at the Dairy 
Building and t&o at Hillside Annex were prepared for inspection 
by representatives of the Department of Public Safety. Six air 
tanks were also prepared for such Inspection* All boiler and 
pump appliances were checked and repaired if indicated* 

7 «» ffS-g® Protection* Weekly fire drills, attended by patients 
and employees, were held* Weekly fire inspections of tine hospital 
were made by the Engineer's Department and frequent inspection 
visits were made by Worcester firemen* 












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107, 



All fire extinguishers were recharged or checked as to t&eir 
condition* A new rubber-lined fire hose was purchased for 
Hillside and over-age hose was replaced at the hospitals 

Sprinkler systems were checked twice weekly* Ward personnel 
were questioned regarding knowledge of fire rules and precaution * 
Registers and ventilators were checked regularly to prevent 
collection of combustible material* 

B* Summer St reet E epartment 

•MWMMMMM* ■l yiHXim i Wil l *«D»irtM«>MNM«MIM«lHW 

lo Personnel * As stated elsewhere in this report, Parrand 
H* Van Dyck resigned as Chief Engineer on September 15, 1952 
and Howell H« Gordon was promoted to succeed him on September 15, 
1954 c 

2* Fuel Consumption 

Coal 9 Bituminous 1,18905 tons 

Coal, Screenings 50 « 5 tons 

Gas 541,900 c«c»f» 

Electric Power Purchased 252^400 K»W.H« 

Water Seed 5,368,700 c»f . 

3 * Electrical Work * Kine electric fly catchers and an 
electric clock were installed in the kitchen* The R*C«A. radio 
speaker was repaired on three occasions* A new electric line was 
Installed for the coffee vending machine in the Center Buildings 
She wiring and light fixtures in the holler room were renewed as 
was all wiring to irons in the laundry* Service was maintained 
to all light fixtures, switches, outlets, and hand iron cords 
for the laundry building* 

4* Plumbing; and Steamfittlng * A new sink and garbage table 
were installed in the female cafeteria* Hew double faucets were 



put In tfe© fcitch&m« Sorvio© was gi^n to t&essaos&afclc -©©.top 
control ifeXv&q^ wat©s» fauceta* water oloaetfl a sliowox>s s *mt©s» 
linois., etesm lio©3 9 seadlatoa?©, ate* 2k© thy©© Ineft iron pip© 
cold tmfeer supply Has tto th© fcollox* tooo ©mi teofc mfcoa* boat©* 
me x?©p2»©©& wltfe tee© lnoh eopp&y tufcii*g» FertgHfive f ©et of 
tb© higfc pressure stoam Xlae to th© kitchen wae *©plac©d with 
*wo lno& l3Poa pip©* cuvS repaid wcstSc wag doae or oish&2» parts of 
t^se line* Baspgeasy g©s«vlce was jpossdos'ed for plugged toilets » 
waeb "bowleg fl©03? draiasj, st»» 

5 * fffefrfrfftfoft* 33.fc&0a» laussfiry, and «9*ing ipooia zaae&ii»3*y 
«ras oorviired woofely and rap&lffed ttber© necessary* Boilers wor© 
eleaneda vasbed* and laspco ted» Hew food pip© busblag and pipe 
fos* '*&© ntattfe&r 2 "ooiley -sras in© tailed. Food pipe 1» ntsnb©2» 3 
bollea? t?a& s*opairod« 

s * I&tift ££B£8SiS&fiS+ ^^ &**! i © involving eatlpo patient- 
eBrp3L®33B^ population t^s>© JssM ©aoh ¥©eko FItb Inepoetlooe of tfca 
hospital wor© made toy s^presenfcatlves of tbe Wosrosstesr Fisn» 
S^pa5?*taa©nt» 2&© spslnlelos? oysteai and fir© alawa oystaax wore 
t©st©d st weejcly int©3?wals* &XL f 1p© ©aEta&gu£sh©2*a ©eye 2»©©faeok@d 
and Soda &eld -ejitiBgixishovs were refilled* 



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109, 



MAINTENANCE DEPARTMENT 

The ordinary maintenance and repair work has been carried 
on as usual during the past year* plus many other projects » 

Renovation of the following has been completed by our own 
personnel: 

Washburn Building 2 and 3 » Repaired windows and frames; puttied 
and painted » 

Salisbury 1 and 3 * Washed ceilings and walls; repaired all broken 
plaster, window frames and sash* doors and door jambs Q Ceilings 
whitened; wall and woodwork painted two eoatso Aluminumed all 
radiators and pipes » 

Folsom Porch 1 and 2« Washed end cleaned both porches and nece- 
ssary repairs made* Calsomined ceilings* Walls given two coats 
of paint ., 

Hydro Cafeteria * Washed ceilings; repairs made and celling 
calsomined • Dining room, kitchen and two halls completely reno- 
vated and given two coats of painto This represented the final 
work on this cafeteria which had previously been enlarged and 
rearranged by contract project* 

Thayer Diet Kitchen *, Ceilings and walls washed, repaired and 
given two coats of painto Floor cleaned and shellacked. 
Dairy Group, which consists of Cow Barn, Ray Barn, Bull Pen and 
manure Pit,. Necessary repairs made to all wood work; sanded bad 
spots; puttied and caulked all holes « Buildings given two coats 
of paint, including screens o Broken glass re«»set* 



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scf XX« ftwiir -*I;£i3tr baa . 

tct»t ■toofc f>aa o*xoo£> t £f«Ai Em 
.a 6«Bt«iliac.-' > A ..aifraoo ow* betf/tlao. 

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Vegetable Barn * Replaced all broken and split clapboards* Sanded 
and puttied and painted entire building two coats * 
Maple Cottage o necessary repairs made to all woodwork and shingles 
In preparation for staining; trim and porches all given two coats* 
Farm Cottage * Broken clapboards replaced 5 new bulkhead o Renovated 
part of front porch.; caulked and puttied holes* Entire building 
given two coats of palnto 

Farm Garages * Seven stalls* Doors repaired; brol-en glass replaced 
and two coats of paint applied* 

Elm Cottage . Outside completely renovated and two coats of paint 
applied* Elm Cottage B* Apartment* Ceiling and walls In kitchen 
and bathroom washed. Ceiling calsomiaed® Walls and woodwork 
given two coats of paint* All floors cleaned and shellacked* 
Wheeler Cottage * Necessary repairs to clapboards and trim made* 
Sanded and scraped loose paint* Puttied and caulked all holes* 
Entire building given two coats of paint* 
Avenue Cottage 1-2-3-4 « Outside repairing of all woodwork* 
Caulked and puttied all holes« Two coats of paint applied* 
Quonset Huts * The last two huts were erected with concrete floors 
and double doors front and rear* The completed unit now consists 
of four huts* All were completely painted with two coats to metal 
and woodwork a Work was begun on a long, truck tail-board level 
loading platform at the rear of these huts which are located he- 
hind the Straw Barn* 

Two Stall Garage * Erected to house new farm truck and bus* This 
consisted of a brick addition, wiifc, roof and overhead doors* to 
the open stalls adjacent to the Main Garage* 



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sod orti awX-Q XlB aario*s«K| ba- 

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newfctflal xil eXXav . ifl gnXXJU 

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Summer Street Department . Third floor-Center, complete renovation* 
Floors sanded and refinished; ceilings washed and whitened; walls 
papered* Kitchen remodeled; new cabinets installed, inlaid 
linoleum laid on floor* Engineer's office - ceilings and walla 
washed and calsomined* Walls and woodwork given two coats of paint » 

lard S and Ward 11 were completely renovated; regular main- 
tenance to the buildings Included windows, glass, plastering and 
painting* 

Sargent Building . Rooms 29-42 * Ceilings and walls washed* 
Ceilings calsomined* Walls and woodwork given too coats of paint 
E*B* 4 and 5 * Ten rooms renovated* Ceilings washed and calsomined* 
Walls and woodwork given two coats of pninto Floors cleaned and 
shellacked* 

Radio Room Area . Rooms and stairway renovated*. Woodwork and 
plaster repairs made* Celling whitened* Walls and woodwork given 
two coats of paint* 

A large amount of repair work was done to the slate roofs, 
both at the Main Hospital and Summer Street Department* 

The window screen repair work has continued to be a large 
project* Approximately 600 new screens were made* 

The usual carpenter repair work has been done on all windows , 
such as new box casings* new parting beads and window cords* This 
work is necessary to all windows throughout the hospital* 

The patching and plastering of walls and ceilings in wards 
and cottages is a continuous necessity for proper upkeep* 

The replacing of window glass is again tremendous* Over 3800 
panes of glass, 5000 feet of window cord and 1300 2bs« of putty used. 



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fol-alni Bi eufa/iJttfas 

ellaw ftrtB sgniX Goi^c e'aoar 

bad salwJu&i t£g ^awobal 

oftadtamr • asaJbll 

i*X*j lo atfaoo £3 a&fc" 

JtaaJtafOfeXaa fuxa &edtL.w eaaltJtoO efied 

Iwsa il«x©«£>o tart ova 

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aftaM cti ayx-'l-rja Ana bXI -. - ' ~ 2-»-.iX*£»tfB iX?x -■— S' -''-' ; & - ; -: 
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A continuous amount of lock repairing, such as resetting, 
ins telling and losy making, was carried on throughout the year* 

The following major projects were carried on by contracts 
Farm Bouse * Work was begun on March 9, 1963* by I» Tapper & Son 
on a project to renovate and remodel two floors of this building, 
providing us with five apartments for personnel* The project was 
well advanced as the year closed* 

Kitchen Area* Kiesseli and librae Co* completed a tiling project* 
One side walls and floor of the Tin Washing Boom were tiled* The 
floor of the Ice Cream Making Hoom was Idled* The area leading 
from the Kitchen, to the Scullery bad its side walls and floor 
tiled * 

New Male Bathing Unit * Peabody Construction Company » This new 
unit Is located against Apple ton and Lincoln buntings* and 
incorporated into the basement of those buildings* Work was be- 
gun in the previous year on January 90, 19SS, and dragged on 
during the current year without completion* 

E xecutive Buildi ng* A* Belanger and Sons* Repolntlng of masonry 
and caulking of window frames was done on the east side of this 
building* 

Cannery Roof * This was covered with asbestos shingles by outside 
labor* supervised by the l&lntenance Department* Three metal 
roof ventilators were installed* 



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■ ' ■ • 

•eJtei* 1c • 

- 
Jjatfea 






U3o 



MATRON '.£ nftV>AT.'i*TEi.TT 



Hits department has functioned well under tie le i 
of Lillian Q. Carr. 

The Sewing Boon fabric:, cod over 39,000 now articles. These 
included sheets, pillow slips, patient's hospital johnnd , 11 
types of towels, "strong blankets", curtains, soft s.. , n»s 
shirts, bathrobes, "strong dresses", etc. 

Hie Mending Room hrs serviced clothing and linen n< or 
repair of hone fabric ted articles, purchased goods vnO 
clothing worn by patients hero. Over 61,000 items we: e . 
this year. 

The Marking Roon applied identifying nark or stemped 
to nearly 18,000 articles. Tliis figure votild be nuclj greater, 
v.'c e it not for the fact that nuch of the marking is uo::e on t ? 
in t .e clothing offices aid linen rooms which s rve as control 
centers. 

The natron's Department served as a distributing and control 
center for household supplies issued to some 29 units t rou ..hoi t 
the hospital 

The Industrial Therapy Shops, heado ' by 7ran:: R. Proctor, 
p-.ive occupation to an average of 45 patients daily .iuri.v the ye 
and performed a variety of cervices useful to tie hocpit; 1 
t lese the more numerous iters were: 

Mimeograph co ies i-.ic.Cg ...... 186,910 

Men's outer clothing repaired 

..a! pressed „ r'.l 



U4. 



Articles of furniture repaired 1,014 

Chair seats repaired 98 

Furniture reu;hol stored 26 

Window shades made . 259 

New pillows made 136 

Hew mattresses made 183 

Bed frames repaired and painted. .... 322 

Bed springs repaired 133 

Shoes half-soled and healed (prs.) . . . 659 

Hew Men*s coats made 4.07 

New lien's pants made 297 

Ediphone cylinders shaved 2,0A6 

Eg.2 rugs made. . . 281 

Toweling woven (y&s.) 1,559 



215« 



WOUfoN'S ATOCELXAgy 

The Woman* s Auxiliary* which began as a group of staff wives 
In 1930 j> has expanded and is now a large enthusiastic organization 
composed of both women from the general community and of hospital 
employee's wives* Xt holds regular aionthly meetings from October 
through June each year and has been of significant assistance 
to the therapeutic efforts of the hospital* 

Perhaps one can best sense the spirit of tfals group by 
inclusion of a portion of the report submitted by the president, 
Urso Clayton X>« Jenks, to its annual meeting in June* 1953* 

"Sfeaabers of the Auxiliary and Guests: 

Our Constitution states that the object of the Woman 1 s 

Auxiliary to the Worcester State Hospital shall be to aid the 

Board of Trustees and the Superintendent of the hospital in 

carrying out the purpose and functions of the hospital* These 

are primarily: 

A* To interpret the hospital to the community* 
B» To help support financially, and otherwise, the 
preventive work carried on by the hospital* 

Wo have made a conscious effort to interpret the hospital 

to lhe community o To this end* each month* invitations were 

sent to each member of one of the large women's college clubs of 

Worcester to be our guests at our regular monthly meeting* Thus, 

we invited the member's of th© Smith,, Vassar, ffit* Hblyoke and 

Simmons College Clubs and the members of the Clark University 

Ffe.cu2.fey Woman's Club* Each time a dozen, more or less, accepted 

and came to our meeting* It was satisfying to know that these 



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college women had been personally told that there was a Woman's 
Auxiliary at the Worcester State Hospital* and that our members 
were earnestly striving to learn the fundamentals regarding 
emotional problems and mental healtho 

Also* our superintendent's wife* Mrs« Bardwell 1» Flower » 
as well as your president^ has addressed during the year several 
church groups and Women's Clubs telling them aomefchizig s 
hospital and the patients and especially about the work or the 
Woman's Auxiliary.* 

Before the Fashion Show which we gave for the patients^ 
Lyda Flanders gave me ten minutes of radio time on her fifteen 
minute program* The Sfodern Kitchen • I thus had time not only 
to ask for donations of good used clothing suitable for a Fashion 
Show but also to explain that the patients were people with the 
same feelings of pride , pleasure and discontent that we feel» 
Immediately after the broadcast p people began to leave bundles of 
clothing at Mrs* Flanders 5 of flee* I wish there were time to 
repeat here the messages they left with their bundles * Several 
said they were happy to give clothes they would have continued to 
wear* if in so doing 8 they could make the sick people happy at 
Worcester State > On© woman wept as she brought in a carload of 
beautiful clothes g explaining that they belonged to her recently 
deceased sister who had been a patient at Worcester State,, dis- 
charged quite well and normal , had married and had had many happy 
years as a wife and mother* Her gratitude to Worcester State 
could hardly be repaid by these clothes, she wept& 



117, 



All of thla shows that the public Is not indifferent and 
will become interested and anxious to help If the Auxiliary will 
but point the way* 

Otoe Fashion Show itself was wonderful* If fine feathers make 
fine birds, certainly the transformation was spectacular* Depressed 
and rather bedraggled women in their cotton dresses were trans- 
formed into radiant fashion plates* After each had had her hair 
dressed^ make-up applied* and gotten into her beautiful outfit 
complete with nylon stockings, hat, bag and other accessories,, 
she certainly looked like a million dollars * Saey gased at them- 
selves in f&e mirror* and said incredulously, "Is that ME?" It 
Is a pleasure to recall the poise and confidence with which each 
walked alone across the stage to music pivoting slowly as the 
commentator described her costume* Since each kept her outfit, 
the stimulus lasted, and the next day, the ^models" staged an • 
impromptu fashion parade of their own throughout the hospital-* 

The Open HOuse definitely comes under the heading of inter- 
preting the hospital to tgie community* We mailed 800 invitations 
and secured newspaper and radio publicity* We served a delightful 
tea to our guests in B»Ba 2« At the ceremony In Sargent Hall, 
we were happy to assist the hospital by furnishing the awards to 
the tsro rusmera-up in the Attendant-of-the~Y©ar con tea t» We gave 
Mr« l&unberg from the male side and Mrs* Rennault from the female 
side identical mahogany self-winding electric clooks with 
illuminated face a 

Just & brief summary of the work that we did for the patients <s 






■ 






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u*. 



At Christmas as a result of our efforts j> many hundreds of glf ts 
were donated for Christmas gifts to the patients* Again* 
Mrs a Flanders permitted m© to make a radio appeal for gifts, and 
again, as they were brought into her office , the donors would 
say that it had never occurred to them that they could help the 
patients at Worcester State* It was only a small group of us, 
at this busy time of year who spent several wearisome days 
Chris tma s wrapping these articles » A gift card attached to each 
present displayed the patient's name and each patient received a 
different and a personal gifts 

Also on the Sunday evening before Ghristraas^ we sponsored 
our usual carol sing throughout the lain hospital o 3his project 
has grown each year* Four years ago,, when I was program chairman, 
I asked the Pilgrim Fellowship (young peoples group} of the 
Boylston Congregational Church if they would like to sing Christmas 
carols at the Belmont and. Summer Street hospitals * A small group 
responded eagerly , and so great was their enthusiasm that the 
young minister who accompanied them discarded his prepared sermon 
for Christmas Sunday, and told in a simple, moving and human 
manner the experiences of his young people and their sincere 
desire to bring joy and brightness of Christmas to the State 
Hospital™ She next Chris teas (three years ago) most of the youth 
of Boylston were waiting on -fee church steps at 6 PoM<» for the 
chartered bus which would take them to the hospital* The next 
Christmas {two years ago) the First Baptist Church heard of this 
enterprise and asked if their young people could join in the carol 



119, 



singing o This worked out very well, on© group talcing the female 
side and one the male side,, and then crossing over to the other 
sideo Thus each ward had two different waves of youthful singers 
pass through which made It more of a party evening for each ward* 
This Christmas, X received a letter from Mr» Hickman* director of 
music at Central Congregational Church, asking if a group of their 
young people might sing carols through the hospital corridors or 
wherever directed* 

Just what to do witii all this wealth of material was a hit 
of a problem* but w© gratefully told them all to come and had 
three groups maabering in all some 200 who trouped all over the 
hospital in and out of wards from Ohs first floor to the sicker 
wards on the third floor o It was in on© of these third floor wards 
that Bro Nelson who was conducting the tour pointed out to me a 
woman patient sitting up in bed singing lustily with the carollerso 
"That is the first time she has spoken since entering the hospital,* 
he said* Apparently some repression had been broken down by the 
familiar carols and the whole-hearted enthusiasm of the boys and 
girls a 

Although these young people wanted no reward* the Auxiliary 
felt that it might be wise to make their final impression not a 
hospital ward but a social party, so in E»B*2 we regaled them with 
punch, sandwiches, cakes and cookies o 

We also helped a man patient who was leaving the hospital to 
reestablish and furnish his home, giving living room furniture and 
sheets, pillow cases and towels «. We paid for a specially built-up 



120 o 



shoe ordered by Sfes* 01i\>e Soman,, head social worker s for a lame 
woman patient who could not walk without the special shoeo 

Ohese are a few of the high lights of the year* We could 
have done better and we will in time a However # we bar© had a 
busy ff interesting and rewarding winter.. Each of us felt we were 
doing some thing worth while » n 



121. 



FINANCIAL REPORT 
Worcester State Hospital 
1953 

To the Department of Mental Health: 

I respectfully submit the following report of the finances of this institu- 
tion for the fiscal year ending June 30 , 1953 , 

STATEMENT OF EARNINGS 

Board of Patients ; 

Private ...... . . $ 182,687o06 

Cities and Towns, o o o * . . ..«...«. 

Department of Mental Health 40,333.11 

$ 223,020<,17 

Per§2SSl Service^: 

Labor of Employees .0.0.0.00. .. 
Reimbursements from Board of Retirement . » 

Sales and Rent? : 

. OOs* o oooo«e»*oeoo • • • » o o 5VU>5 -t 9 

Clothing and Materials «, .......... 1.00 

Housekeeping Supplies • •«...... . 

Laboratory and Medical. <> ........ . 22.69 

Heat and other Plant Operations ••«... 24.57 

Farm and Grounds. ..... ... 6,267*59 

Automotive. 

Advertising and Printing. 

itopoxrs .. .......O.C..OO.O. ^^w?.oo 

Special Supplies o ........ ...... 2*25 

Office and Administrative 

Equipment 

Special Outlay. 

Furnishings ..«.•«••«•*•«.».. 37.00 

Rents - Employees ...... ... 27,290.36 

Rents Others. .........•••*. .. 497.88 

Meals Employees I6,25lo00 

Total Sales and Rents 5l,310„15 

Miscellaneous : 
Interest on bank balances ......... 

OliJjLXry ......aou..o..«.a.i> lj /Olg77 

Total Miscellaneous 1,781.99 



• o»*e-a«e #•••»«** 
£»e*««»o**eoo 



'e«oQo*#o««oa»oov 



122. 



Total Gash Receipts reverting and 

transferred to State Treasurer ♦..«,» 276,H2,>31 

Total Earnings for year (page 9»Xnst« Income) 276,. .''.91* /.ft 

Accounts Receivable outstanding July 1, 1952 143 .69 
Accounts Receivable outstanding June 30, 1953 226o94 
Accounts Receivable increased ...... . 83*25 



MAINTENANCE APKiOPRIATIOB 

Appropriation, current year 3»008j,711.41 

Total 3,008,71JL41 

E xpe nditures as F ollows ? 

01. Salaries, Bermanent 1,97a ,940*73 

02. Salaries, Other 38,833.02 
03o Services - Son-employees 23,700.00 

04. Food for Persons 415,751*64 

05. Clothing 59,013,83. 

06. Housekeeping Supplies and Expenses 71,726.19 

07. Laboratory, Jfedical and General Care 47,947.79 
03* Heat and Other Plant Operation 136,331.75 
09* Farm and Grounds 42,319.2$ 
10. Travel and Automotive Expenses 5 , 286*39 
Ho Advertising and Printing 375*22 

12. Repairs, Alterations and Additions 62^615.78 

13. Special Supplies and Expenses 61.68 

14. Office and Administrative Expenses 11,231.01 

15. Equipment 22,688.51 

16. Rentals 487.50 
18. Special Outlay 

Total Maintenance Expenditures 2,911,298*30 

Balance of Maintenance Appropriation, June 30s, 1953 97, 413 .11 



SPECIAL APPROPRIATIONS AND SPECIAL OUTLAY 



123. 



Balance July 1, 1952, brought forward 
Appropriations for current year 
Total 

Expended during the year 

Revarting te Treasury of Commonwealth 

Balance June 30, l95->-> esreffed to next year 



None 
Rose 

Hone 

None 

Bo-do 



PER CAPITA 
1. During the year the average number of patients has been 



2 ^otal cost of maintenance 

3. Equal to a weekly per capita cost 
of (52 weeks to year) 

Un Total receipts for the year 

5o Equal to a weekly per capita of 

6. Total net cost of Maintenance for year 
(Total Maintenance less total receipts) 

7o Net weekly per capita 



2,911,298.30 

20,03 

276,212.31 

1.90 



18. IS 



Respectfully submitted, 

A/ 



FINANCIAL STATEMENT VERIFIED 

(Under Requirements of C. 7, S 19 QL) 

Date: October 29, 1953 

By_ r . _/ r a/ n _ J^sepfr A. Frenaey 

For the Comptroller 

Approved for Publishing 



2788 



2,635,185.99 



Paul P,> Foran, 



Treasurer 



/e/ Ralnh E, Houston 



Acting Comptroller 






' 









lSgS£ 22 POHJIATIQg? 12Uo 

July 1, 1952 to Juno 30, 1953, 
■ 

1 Total M& ISB32& 

&ti§ntg On Booki At Bgginning Of ££§£ 

lo In Hospital <> • ••••••••••••••••••••«• 2831 1316 1515 

2. In Family Car© (Public Hospitals Only) .........<> 47 9 38 

3. On Visit Or Otherwise Absent But Still Carried On Boobs . • 357 158 239 
4* Total On Books At Beginning Of Year (Sum Items 1,2,3) . « « 3275 1483 1792 

A dmissions During Year (Exelusiv© Of Those Returned From Visit, 

Escape, etc.) 

5o First Admissions ,«•••••••«••••<>«••••• 629 324 305 

6 e Readmissions ««••••••••••••••••••••• 209 M)3 I ** 

7. Transfers Prom Other Hospitals For Jfental Disease Within State 26 XI 15 

8. Total Admissions • •••••••••••■•••••••• 438 

9. Sum of Items 4 and 8 (For checking) ••••*••••*•• 4139 1921 2218 

Separations During Year 

10o Discharges D? -4, ect From Hospital . ......<> o 231 161 

llo Discharges WMle On Visit, Escape, Etc. • •••••••■» 308 113 193 

12o Total Discharges .........«......•••* « 539 276 263 

13. Transfers To Other Hospitals For Mantal Disease Within State 114 58 

H / irt Deaths In Hospital •••••«•••«»••.••••«•• 283 144 139 

15. Deaths Of Patients On Visit Or Otherwise Absent From Hospital 3 2 

16* Total Separations {S«u Items 12,13,14,15) 939 480 459 

Patients On Books At End Of Yg_ag 

17c Resident In Hospital At End Of Year ............. 2745 1257 1488 

18. In Family Care «••••••••••••«•••••••• 54 10 M 

19* On Visit Or Otherwise Absent But Still CfcVrled On Books . « 401 174 227 

20* Total On Books At End Of Year (Sum Items 17,18,19). . . • . 3200 1441 1759 
21. Sua of Items 16 and 20 (Should Equal Item 9 if all entries 

are correct) ........... 4139 1921 2218 

22 o Average Daily Patient Population In Hospital During Year . 2777.42 1287.67 1489*75 

23. Rated Capacity Of Hospital. • . ..... 2356