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 situations 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.”

I found that an unnecessary and continued lack of outdoor exercise tended to multiply deeds of violence. Patients were supposed to be taken for a walk at least once a day, and twice, when the weather permitted. Yet those in the violent ward (and it was they who most needed exercise) usually got out of doors only when the attendants saw fit to take them. For weeks a ward-mate – a man sane enough to enjoy freedom, had he had a home to go to – kept a record of the number of our walks. It showed that we averaged not more than one or two a week for a period of two months. This, too, in the face of many pleasant days, which made close confinement doubly irksome.