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Where a Mind Could Find Itself Again

By Anne Bennett Swingle

Artfully designed to heighten emotional healing, Phipps
Psychiatric Clinic once was also derided for its excesses.

Semi-quiet ward

Semi-quiet ward, Phipps Clinic, c. 1939

The beautifully engraved invitations had long since been mailed out, and the day had arrived: April 16, 1913, the official opening of the new Henry Phipps Psychiatric Clinic. On hand were famous figures in medicine, including Adolf Meyer, Hopkins' psychiatrist-in-chief, and even the great Sir William Osler, who had returned to Johns Hopkins from his post as Regius Professor at Oxford University for the occasion. Philadelphia steel magnate Henry Phipps, who had endowed the clinic, took his place among the trustees. It was a rarefied intersection of medicine and philanthropy, and in this crowd, one man, Grovsenor Atterbury, was a relative unknown.

Atterbury, though, knew more about the building than anyone else, for he was the architect who'd designed it. For him, the opening ceremonies represented the culmination of nearly five years' work. With Meyer, he had traveled abroad to see other psychiatric institutions and overseen every detail of the clinic's construction. Both were champions of aesthetics in hospital design, and now, on this April afternoon, Atterbury was full of hope that the crowd would appreciate his meticulously planned clinic for its unusual sensitivity to beauty.

A graduate of Yale and the Ecole des Beaux-Arts in Paris, Atterbury had worked at the New York firm of McKim, Mead & White, building suburban and weekend houses for the wealthy. But in 1908, the year he was retained to do the Hopkins project, he had been busy in New York City's borough of Queens laying out Forest Hills Gardens, America's first "garden community" for the working classes. That same year, another Yale alum, Clifford Beers, published The Mind That Found Itself, a shocking autobiographical account of the inhumane conditions in a turn-of-the-century insane asylum. The exposé spurred Phipps and Atterbury to alter the status quo for psychiatric patients.

Semi-quiet ward

Adolf Meyer, psychiatrist-in-chief

But the challenges Atterbury faced at Hopkins were formidable. He had only a small plot of land to work with, so he knew he'd have to design a multistoried building. Into it, somehow, he'd have to fit patients with disorders ranging from simple disturbances to outright psychoses. Meanwhile, the structure's exterior would have to conform with the surrounding buildings of The Johns Hopkins Hospital. To counterbalance them, Atterbury wanted a bright interior with lovely spaces that let the outdoors in.

And so he placed the labs and administrative offices along the north side of his building and the quarters for patients into the light-filled wings that extended south. In between, he sketched an outdoor courtyard with a pond and cloistered walk. The entrance flowed directly into a reception room with graceful columns and wood paneling. In the basement there was a dispensary for outpatients; on the first floor, wards for the "excited" patients; the second, spaces for the "semi-quiet"; and the third, rooms for the "quiet." The fourth floor was reserved for 18 private patients, with the women on the east side, the men on the west. These quarters had separate dining rooms, suites with sitting rooms, bedrooms and baths and two trellised roof gardens. A billiard room and a recreation room with a stage, piano and even a pipe organ were on the top floor.

The Phipps groundbreaking took place on July 10, 1910.

As construction proceeded, Atterbury corresponded with Meyer about every detail: Push-button light switches or regular, he wanted to know. Would curtain rods be objectionable on the grounds that patients might use them for suicidal purposes? Grills on the windows? Administrator Winford Smith had vetoed horizontal and vertical bars for fear they could be climbed upon.

Semi-quiet ward

Front entrance in the famous Phipps Clinic
The clinic from behind
The 5th floor auditorium (which housed a pipe organ), where patients gathered for programs.
Cloistered walk with courtyard

But when it opened, Phipps was a marvel to behold, right down to the fine linen towels, Haviland china imported from France and monogrammed silver for private patients. Budget-conscious Smith, a practical sort who would devote a career to reducing health care costs, couldn't abide such expenses. On Jan. 14, 1914, he fired off a stinging memo to Atterbury listing his criticisms of the Phipps Psychiatric Clinic point by point: included were such items as exam rooms "about three times as big as they need be...too much copper and brass...extremely expensive to maintain."

Atterbury had his vengeance. His lengthy, near-poetic defense of Phipps' design, "The Architectural Problem with Particular Reference to Aesthetics and the Art of Architecture," arrived in Meyer's mailbox in December 1914 and included an attack on Hopkins administrators. On Sept. 25, 1915, the opus appeared for all to read in the Journal of the American Medical Association.

"In treating the patient, do not forget the man," Atterbury began grandly, borrowing a line inscribed on the entrance to Virchow Hospital in Berlin. With Smith, Atterbury was merciless: "The writer is tempted to take a deprecatory whack at the hospital superintendent...a fellow whose existence depends on lavish economy in other people's affairs," he wrote.

Phipps was Atterbury's first and last hospital building. The architect went on to become a consultant to the University, design the American Wing of the Metropolitan Museum of Art and pursue his interest in prefabrication. But Phipps had cemented a friendship between Meyer and Atterbury that would continue throughout their lives. In the spring of 1944, Meyer, 77, wrote to Atterbury, 74: "Your letter came just one day before the anniversary of the Clinic, April 16th. I remember so well the April 16th mirabile dictu, of years ago...The Clinic has been an unusually gratifying job of yours."

Indeed, despite the classic confrontation between the creative architect and the utilitarian administrators, the Phipps Clinic rose to worldwide fame. It was here that Meyer put together his world-famous academic-psychiatry service with its sought-after residency program. And it was through Phipps, only the nation's third university psychiatric clinic, that care of the mentally ill finally was transferred out of the hands of asylum superintendents and into general hospitals and medical schools. Most important, Phipps brought home the lesson that a healthy environment could aid the healing process.

Patients were treated at the world-famous clinic until 1982, when the Meyer Building was completed and Phipps was converted into offices. In 1990, the out-of-date building was nearly razed to make room for a new cancer center, but historic preservationists won the day. Today, looking much as it did on that April morning nearly 90 years ago, the Phipps Building stands as a proud monument to psychiatry's early days as a true medical specialty.

 

Photos courtesy of the Alan Mason Chesney Medical Archives.

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