With that I uncovered to the doctor a score of bruises and lacerations.  I knew these would be more impressive than any words of mine.  The doctor put on a knowing look, but said nothing and soon left the room.  His guilty subordinate tried to appear unconcerned, and I really believe he thought me not absolutely sure of the events of the previous night, or at least unaware of his share in them.

XXI

Neither of the attendants involved in the assault upon me was discharged.  This fact made me more eager to gain wider knowledge of conditions.  The self-control which had enabled me to suspend speech for a whole day now stood me in good stead.  It enabled me to avert much suffering that would have been my portion had I been like the majority of my ward-mates.  Time and again I surrendered when an attendant was about to chastise me.  But at least a score of patients in the ward were not so well equipped mentally, and these were viciously assaulted again and again by the very men who had so thoroughly initiated me into the mysteries of their black art.

I soon observed that the only patients who were not likely to be subjected to abuse were the very ones least in need of care and treatment.  The violent, noisy, and troublesome patient was abused because he was violent, noisy, and troublesome.  The patient too weak, physically or mentally, to attend to his own wants was frequently abused because of that very helplessness which made it necessary for the attendants to wait upon him.

Usually a restless or troublesome patient placed in the violent ward was assaulted the very first day.  This procedure seemed to be a part of the established code of dishonor.  The attendants imagined that the best way to gain control of a patient was to cow him from the first.  In fact, these fellows—­nearly all of them ignorant and untrained—­seemed to believe that “violent cases” could not be handled in any other way.  One attendant, on the very day he had been discharged for choking a patient into an insensibility so profound that it had been necessary to call a physician to restore him, said to me, “They are getting pretty damned strict these days, discharging a man simply for choking a patient.”  This illustrates the attitude of many attendants.  On the other hand, that the discharged employe soon secured a position in a similar institution not twenty miles distant illustrates the attitude of some hospital managements.

I recall the advent of a new attendant—­a young man studying to become a physician.  At first he seemed inclined to treat patients kindly, but he soon fell into brutal ways.  His change of heart was due partly to the brutalizing environment, but more directly to the attitude of the three hardened attendants who mistook his consideration for cowardice and taunted him for it.  Just to prove his mettle he began to assault patients, and one day knocked me down simply for refusing to stop my prattle at his command.  That the environment in some institutions is brutalizing, was strikingly shown in the testimony of an attendant at a public investigation in Kentucky, who said, “When I came here, if anyone had told me I would be guilty of striking patients I would have called him crazy himself, but now I take delight in punching hell out of them.”