An aerial view of the Southwest Virginia Mental Health Institute when it was known as Southwestern State Hospital.

Some of the most interesting items that are shared with me at the library come in inconspicuous fashions. They are sometimes brought in old, tattered boxes, milk crates or plastic bags. One day, I walked into my office and found a 35-page typewritten stack of papers sitting on top of my keyboard. The cover page proudly announced the contents—Hospital Hill: An oral history of Southwest Virginia Mental Health Institute.

This project was undertaken in 2004 by Jean Hamm’s Chilhowie High School dual-credit English class. Recognizing that most students groan at the mention of research projects, she decided to try something that would make the assignment more interesting for them. After some discussion, the students settled on the topic of Southwest Virginia Mental Health Institute. They compiled a list of questions for oral history interviews and went to work. The result of their efforts is this brief history along with recollections of those who used to work on “Hospital Hill.”

The booklet begins with the following highlights from institution’s history: “The Southwest Virginia Mental Health Institute was first established in 1887 under the name Southwestern Lunatic Asylum. Located in Marion, Virginia, the hospital provided a central location between existing mental hospitals. Previously, people from our locality traveled to Huntington State Hospital in West Virginia. The need for a closer state hospital arose as existing state hospitals were becoming overcrowded. The General Assembly had allotted money to build a mental hospital in Southwest Virginia in 1884, and after the competition of several local counties, the location in Marion was chosen to be the best place for the hospital. Construction began in March of 1885 and the main building was completed in February of 1887.

“The Hospital was first designed to be an isolated, self-sufficient system. Therefore, the hospital ran its own farm, which consisted of 199 acres of state land and 1,200 acres of rented land. Patients were allowed to work on the farm as a form of therapy. They milked Holstein cows, raised wheat, straw, hogs, beef cattle, and had their own laundry and sewing services. They produced everything they used on the hospital grounds. However, in the 1940s, concerns about patient exploitation (at other mental health facilities) led to the break up of the farm. The livestock was sold at public auction, as was some of the land.”

“In the early days of the hospital, people were admitted for several reasons, such as spider bites, disappointment in love, excessive tobacco use, fright, financial trouble, jealousy, lightening strike, over-study, overwork, opium habit, religious excitement, old age, and heredity. The people admitted to the hospital usually spent the duration of their lives here, and patients were assigned to buildings based on geographic location, not age or mental illness, as they are today. Patients were placed in a building, usually by county. This meant that acutely psychotic patients were in the same building as adolescents, with little regard to mental status.

“The transition from geographic location assignments to special care assignments happened in the 1970s. At the start of the new organization, there were five different wards—the intermediate ward, the long-term ward, the adolescent ward, the geriatric ward, and the forensic ward. Moreover, at this time, the hospital cut down on the number of patients it cared for. The number decreased from 1,600 to less than 176, when the hospital began to focus more on acute treatment and outpatient therapy.”

Following the brief history, the students included stories they gathered from conducting interviews with former employees. The recollections paint a vivid picture of what it was like to work at the facility.

One of the employees that participated in the oral history interviews was Dorothy (Dot) Rouse Poe. She was born in Smyth County on March 26, 1937. She told the students that “she and her brothers and sisters would go out with their parents on Sunday evening rides and go up ‘asylum hill.’”

As a little girl, Dot dreamed of being a nurse and remembered making herself “little nurse hats out of paper. She got married when she was 16 years old and never attended nursing school. Despite working in a hosiery mill, being a nurse was always in the back of her mind. That was one reason she went to work at the mental institution. She also liked the good benefits and good pay. She ended up working there 26 years and 8 months.

“Dot worked on every ward and every shift during her 26 years at SWVMHI. An especially memorable patient for Dot was a woman who literally ate everything that she could get her hands on and proved that nastiness won’t kill you. ‘We had this little old woman on a ward that would eat everything…I mean she ate everything she could get her hands on. Out of the trash, out of the commode—anything. So, one night, I hadn’t been there too long, and I went to the linen room to get a mop bucket and there was a little mouse in it. It was just running around in the bucket, so I ran some water in and drowned it. I picked that little mouse up by the tail and was going to take it to the trash. I was coming out of the linen room carrying that little mouse and a hand reached and grabbed it. It was her. She slapped the mouse in her mouth and swallowed it. And, Lord, that scared me to death and I thought I’d get fired. I could get fired for that and so I thought, ‘Well, should I report it?’ So, I went on to the office and the nurse was there and I just broke down and started crying and she said, ‘Dot, what’s wrong?’ I said, ‘Lord, I killed a little mouse and I was carrying it, bringing it down here to put it in the trash and this patient grabbed it.’

“She just hollered and laughed and she said, ‘Dot, it won’t hurt her. She’s eaten everything. She caught a bat, one time, and ate it, so it won’t hurt her.’

“So, I said, ‘You mean I’m not fired?’ She said, ‘No, indeed, you’re not fired.’

“Now, that really sticks out in my mind. I didn’t know there were people that did stuff like that. But, when you’re mentally ill (and she was mentally ill) nastiness won’t kill you. She lived to be 80 years old.”

Another story was told by Sandy Williams, who worked as a nurse at SWVMHI. She recalled one incident that stood out in her mind—the “story of her abduction.”

“I was an aide with a driver, transporting a patient to Smyth County Hospital for some tests. He was a young boy about 19-years-old and was just real nice. I talked to him all the way up there. He was a little bit nervous acting, though. The young man was in the hospital for cashing bad checks and had jail time facing him. He was at the hospital for an evaluation. So, we were coming back to the State Hospital and we got about to Marion Chevrolet and he came around my neck with a knife and told us to take him to Tennessee. I thought he was just joking with me and I reached up and sliced my finger. The blade was around my neck, and the driver said, ‘We’re not going to Tennessee,’ and I said, ‘Yes, we are.’

“The young main said, ‘If I see one policeman, I am going to slit your throat.’

“How many times have you been through Marion and not seen a policeman? I could just see Kenny Lewis around the corner there, any minute. So, I just tried to keep him calm and I told him that we would be all right, we would do what he wanted to do, just be calm. I said, ‘If you see a policeman, don’t think that they know you are in here because they don’t. You’re going to be fine. Just don’t get excited.’

“So, we got on the interstate and I said, ‘Why don’t you take this car and let me go?’ He said, ‘That sounds like a good idea.’

“I said, ‘There’s a credit card in here and you can go anywhere you want to go.’

“So, he got the driver to stop, made him go around to the back of the car, pushed me out, and so here I was on interstate with blood dripping down my arm. A van from Texas was going north on the interstate and saw what happened, saw him push us out of the car. So, they came back and we called security from their van and they came and got us. They caught the boy four months later, in Oklahoma. Now, he is in jail for 11 years. He got 18 years, with 7 suspended. This was my most memorable job experience.”

The time Jean Hamm’s students took to conduct oral history interviews and compile these experiences into a booklet provides valuable information about SWVMHI, its history and the people who have worked there.

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Margaret Linford is a professional genealogist and is president of the Smyth County Genealogical Society.

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