central state of mind pathology to health
Re-envisioning the grounds of the former Central State Hospital for the Insane, Indianapolis : re-imagining :
land use | culture | community
Updated from Oct. 2009 Whitepaper Bluesky LLC
contents 1 2
Inspiring Past + Present what are they? SEEN
Once Inspiring, Now Blight:
Anomalies and Pathologies
Mental Math the usefulness of ghosts CONCEPT
Deconstructing the Gem a culturally creative vision
depression without patients UNSEEN
SEEN + UNSEEN
The Road Taken greening the ghosts
can brains in jars save us from an uninspiring future?
Inspiring Places Central State Hospital for the Insane, shown in this illustration, was not to be mistaken for a small empire, or, as a 1920 aerial photograph seems to convey, a Bavarian Village. A city within a city, it was separate but selfsustaining, highly organized, architecturlally intricate and a civically optimistic venture on the near westside of Indianapolisâ€”at least as optimistic as insane asylums can be. It provided patients with jobs, clubs, restaurants, working farms, stores, barber shop, bowling alley, gardens ... all in park-like setting including health facilities, a spa, church and counseling as well as dormatories. Such asylums, originally conceived, served to both segregate â€˜abnormalâ€™ populations and provide respite for the mentally ill and spiritually weary. They were not without problems. Albeit paternalistically, these places were designed to treat patients with dignity.
prologue a personal perspective
On the Western Front 1995: I stared west out of my office at a series of silos. At the time, the Eiteljorg Museum of Native Americans and Western Art was all about, and in fact was on, the “western frontier” of Indianapolis. There was no Indiana State Museum, no central canal walk, no sculpture park leading to the Indianapolis Zoo, no Victory Field or Indiana Historical Society. There was just an old paper mill and other vestiges of defunct industry on the White River. How about a mountain scene on those old silos? The West is a “State of Mind” I told visitors, pointing to the iconic Grand Canyon triptych in the front hall. FAST FORWARD: White River State Park, now a polished, multimillion-dollar cultural destination, is a huge part of the city’s identity.
A postcard illustration depicting Central State Hospital for the Insane
what are they?
Travel west, just 12 blocks or so, and you’ll find a new frontier, a wasteland, known as Central State, the grounds of a much-storied former mental hospital. It is now a hodgepodge of use and misuse; the serial subject of land reuse studies; and frequented by ghost hunters. More than 150 acres currently house a mix of depressing late 19th-century and 20th-mid-century ruins of the storied mental institution: barracks-like housing for the Hoosier Veterans Assistance Foundation (HVAF); the Indianapolis Police Department’s Mounted Patrol Headquarters, complete with horse stables and a corral; and the idyllic, well-preserved Victorian Pathology Lab and medicinal gardens stewarded as the Indiana Medical History Museum. Plans for reuse of the old Central State Hospital have come and gone with administrations. Nothing has taken root enough to start with demolition.
wasteland or western frontier?
the mental and physical blight of Central State The seen and known geography of space at the old Central State include the positive and the negative: broken windows and dilapidated buildings; fragmented re-use, including the cityâ€™s horse patrol and veteran housing; potentially promising green space near downtown; old Victorian-style walkways, where patients must have roamed; underground tunnels to make any re-use project unexpectedly expensive; thriving centuries-old sycamore trees; struggling neighborhoods; near-proximity to the White River, IUPUI and White River State Park; proximity to the railroad and two main metropolitan artery streets; a beautifully restored, one-of-a-kind historic pathology building, with tended gardens and museum tours; brains in jars; ominous-looking equipment for autopsies; and a stunning, naturally-lit medical theatre and lecture hall â€Ś
then and now
Mental and Physical Blight Such asylums did not fare well over time, politically, financially and through the changing winds of the social place and destiny of insane persons. The hope, the dream, was, unfortunately, to become its oppostie: hurtful, ill-equipped, unreliable, unaccountable. The Enlightenment vision—ephemeral. Patients were more likely to be isolated from society at large rather than protected. Eventually, the institution became a civic blemish, conveniently hidden behind the perimeters of its once highly organized, planned community; the insane even more unseen. This was part of the general trend or process of institutionalization. In the case of Central State Hospital, grand visions in the hands of the politcally changing leadership of the State, was poorly funded. It was subject to other social and economic forces, including increasingly hostile cultural attitudes toward the mentally ill.
Actually, as far as such 19th century insane asylums go (many of which, by the way, were called “Central State”), most closed during the “deinstitutionalization” of the mentally ill, beginning in the 1960s. Only a handful of the now-dilapidated 19th century gems, along with some 1970s-era, institutional-style buildings, remain of the former Victorian Walt Disneyland for the mentally ill, spiritually tormented and culturally rejected. Freed from increasinglly deteriorated conditions and a society that didn’t seem to care as much, some patients were able to function on their own with new medications. Others are housed in integrated, low-profile social service programs, or in homeless shelters, or live on the street.
Depression Without Patients Now, broken windows and papers still—nearly 20 years after its closing in 1994—lay strewn about its 19th century architectural remains. Late to the cultural trend of de-institutionaliztion, it’s closing was quickened after questionnable deaths were reported in the news.
Though construction is underway to redevelop the land, questions arise about what remains of the history and spirit of the place: the unseen, unknown, never spoken acknowledgements. Broken pieces of puzzle remain. What have we missed, by not asking where they fit in?
anomalies and pathologies
A Well Preserved Gem
The Indiana Medical History Museum is the only remaining—well preserved—original building from the vast long forgotten city of Central State Hospital for the Insane. It is a pristinely preserved gem of history, with a tidy herbal garden maintained in back for the purpose of teaching about the historical uses of medicinal herbs. It was the old Pathology lab, where the brains of the mentally ill were dissected upon death in order to learn more about brain anatomy and function, and hopefully gain scientific insight about the patient’s sickness. Overall morphology and any aberrations were noted. The brain was weighed. Then surgical slices were preserved on slides to note possible lesions in particular parts of the brain. Autopsies were performed for medical students in the lecture hall/theatre. Actual brains in jars remain as part of the museum’s collection. Constituents and supporters of the Indiana Medical History Museum point to this building’s significance as the birthplace of modern psychiatry. But disconnected from its past, it is an outlier among the other crumbling buildings on the grounds.
“the 19th-century brains on display [are] a strange reminder of the building’s past as an insane asylum” (IU School of Medicine News, Dec. 2011)
The Indiana Medical History Museum is located in the Old Pathology Building on the grounds of the former Central State Hospital on the near westside of Indianapolis. The museum represents the beginning of scientific psychiatry and modern medicine while the building itself is the oldest surviving pathology facility in the nation and is on the National Register of Historic Places. The museum maintains a collection of scientific artifacts from the nineteenth and twentieth centuries in a completely authentic setting. Constructed in 1895 and inaugurated in 1896, the nineteen-room Pathological Department Building, as it was then called, is equipped with three clinical laboratories, a photography lab, teaching amphitheatre, autopsy room, and library. (from the website)
A Beautiful Anomaly Even so self-described by a board member, the existence of the Old Pathology building seems something to apologize for ... It is the oddball on the old Central State grounds only because of what is absent. It is also disconcerting to the public, perhaps not unlike a lesion discovered in the brain; providing an unclear yet possibly critical insight and connection to the past ... to the living? Like such “lesions” neuropathologists hunted for, the Indiana Medical History Museum seems to express itself as something haunting, yet highly unique ... On a stormy evening or gray Monday it can feel staged.
the horrifying, enlightening specificity of place
the mental math behind a socially constructed space
seen + unseen
the usefulness of ghosts
CENTRAL STATE HOSPITAL
mentally ill + inspired intentions + brain autopsies on site in Pathology Lab for the advancement of science
mentally ill + uninspiring place
= The name, though critical, is a mask.
Indiana Medical History Museum
It was named the Indiana Medical History Museum as a way of preserving it, growing it and making it more relevant to the public.
+ diaspora of mentally ill to fend for themselves on the street + preserved Pathology Lab as Indiana Medical History Museum + mixed re-use on site
+ problems of finance, staffing, maltreatment, institutionalization and social decay
brain pathology > neurology > psychiatry > psychopharmacology > neurosciences
INDIANA MEDICAL HISTORY MUSEUM
1895: built and used as the Pathology Deptartment of Central State Hospital
1960: closed as a pathology lab but several years of partial use by Indiana University doctors helped ensure the building was not torn down like others.
additional medical history collections
_ Indiana Medical History Museum
1969: established as the Indiana Medical History Museum and began collecting non-athology related medical history items. 1972: placed on the National Register of Historic Places
1984: opened to the public with a space modified for changing exhibit themes.
“Uncontrollable cases were relegated to the hospital’s so-called dungeons, which were described in 1870 by a Central State superintendent as “dark, humid and foul, unfit for life of any kind, filled with maniacs who raved and howled like tortured beasts, for want of light, and air, and food [;…and forced to sleep on] forbidding skeletons of iron.”
(Indiana Public Media, Yael Ksander, 2007)
From a placemaking point of view, we often take for granted a simplicity that is not true. We see what we want to see and set a plan to fix what is visably broken, the seen, the managable, the economically concrete—the physical—under the additional assumption that it is socially and politically neutral. It is too basic a math. If we want to be as sophisticated socially as we are scientifically, we need to take the time to perform a calculus. Sociologically, we need to add synthesis to our analysis: attend to the value of the unseen, unnoticed, unacknowledged categories that frame a particular situation.
Mental Health The fascinating chapters of how humanity has dealt with issues of mental health, especially illness, is juxtaposed locally with: • The historically significant, scientific (pharmacological) problem solving for mental disorders begun by Eli Lilly & Co., still a leading distributor of medications used in a broad range of psychiatric and mental healthrelated conditions.
Medical History The collection and study of medical history locally incluldes:
• Indiana Medical History Museum at the Pathology Lab of Central State • Indiana University Bloomington’s History and Philosophy of Science Department
Recognition of the importance of the brain to humans’ mental experience and mental health has happened locally with: • Opening of IU’s new Neuroscience Center in downtown Indianapolis • Famous TED presenter and author Jill Bolte Taylor, a neurologist at Indiana University Bloomington, whose personal account of her own stroke in My Stroke of Insight has resulted in renewed interest in left/right Brain hemispheric function.
Land, History, Place
Land, History, Place
With its 200 acres and more than 100-yearold trees, the land of Central State, once grand, occupies a valuable plot of land close to downtown. If we take a more holistic look at the land, the history and the place, we might come up with a visual as shown below ...
Former Asylum MINDS What is the scenario or story that tells all the other stories in the most relevant way while helping to solve one or more problem?
brain pathology > neurology > psychiatry > psychopharmacology > neurosciences
MINDS + BRAINS
deconstructing the gem Rather than thinking of the acreage as a well-designed park or sports venue, it becomes instead a healing antidote to stigmas and stereotypes; a state of mind that points as much to the past as to our future; a refuge for Midwesterners ‘caught in the middle’ and an unexpected beacon for those beyond. No longer antiquated, quaint or irrelevant, the Pathology Lab, birthplace of modern psychiatry, becomes a centerpiece of the Museum of the Mind and Brain (MOMB) experience; the brain’s centrality to human development explored; the stories of the Central State “ghosts” shared; the brain’s importance to mental health revealed; the mind’s role in human spirit and society examined. ; the brain’s importance to mental health, and the mind’s role in spirit and society examined and understood. No other institution pays tribute to human beings’ most defining feature.*
culturally creative visioning
A Whole New Mind As Thomas Kuhn’s landmark The Structure of Scientific Revolutions pointed out, anomalies often present opportunities for paradigm shift. In the case of the grounds of Central State, this could be a chance to explain, tell a story—many stories ... Imagine the Old Pathology building, along with its forgotten Central State surroundings, as a seat of rebirth, revitalization, re-imagination ... Imagined at right is a modern, glass and steel, multimillion-dollar research institute, museum and school architecturally embracing its historical anchor. The Pathology Lab, returned to its original name, becomes a raison d’etre for designing a place where mind and brain—neuro-, cognitive and psychological sciences, history of science and medicine of the brain and mind, mental health—create a locally inspiring, regionally (perhaps nationally or internationally) significant center for research, learning and human self-reflection. The drawing (above right) pays homage to the brain’s hemispheres. Two- to three-story wings are connected by an elevated, transparent walkway, resonant of the brain’s corpus callosum. From this wide, transcendent bridge, visitors look up to view the day or evening sky and look down to see the museum—a whole brain, a mind, a conscience. As eyes move down they scan the atrium, discover the curious gem at its center: the only living vestige of Central State Hospital for the Insane.
MINDS + BRAINS meet here, at the birthplace of turn-ofthe-century neuropsychiatry: the Pathology Lab becomes the nucleus, central core and historical anchor for the Museum of the Mind and Brain
Neuroarchitecture, Neuroenvironment What architect wouldn’t want to win this design opportunity? What form would it take? How might it encompass, embrace or connect to the Pathology Lab and surrounding green space? What public and private opportunities for learning, working, playing experiementing and musing might arise? * established enough to have a presence on the world wide web
from pathology to health Bachelard’s Poetics of Space reminds us that exploring the imagined—materially invisible, unformed, conceptual or unacknowledged images—can yield powerful planning tools in re-envisioning and re-imagining urban spaces. We may be more likely to experience what Bachelard described as “a sudden salience on the surface of the psyche.” Though analytics (land use studies, market feasibility, etc.) are critical, an imaginative approach often results in a specific vision that provides a true north from which technical issues can be measured, determined and implemented with purpose. When a ‘prepared mind’ opens itself to experience and intuition a visionary, wild kind of problem-solving specificity unfolds.
Imagine a built-in high school, the Mind School, where students take an active role in creating the museum, exhibits and curriculum; learn about brain development, nerve impulses and advances in the brain sciences; use left- and right-brain learning strategies; develop critical- and design-thinking approaches; and benefit from an advanced literacy curriculum catering to the exploding cognitive, critical and creative, brain development of teenagers. Community service, scientific experiements and student science and knowledge design are built in opportunities.
Neuroinquiry, neuroactivity, neuroconscience Perhaps the aptly named Thinc exhibition design firm engages students in Museum of the Mind and Brain creation, where visitors learn: how nutrition and drugs affect cognitive function; what repeated aggression does to the brain; what depression looks like; how meditation and movement focus attention; how to avoid behaviors and environments associated with mental instability. Immersive exhibits could reveal how the mind reacts to sensory deprivation, as a prisoner of war, neglected child or incarcerated criminal might experience; or how language acquisition works. The importance of thinking and asking questions. Science and art, thinking and feeling meet. There is no limit to learning from changing exhibits on the brain sciences and on human experienceâ€”from religion to politics to artâ€”that impact and influence the mind.
Neuroeconomics Where do neuroscience, cognitive science, neurotechnology, imagination, information technology, creativity, business, green economy, consciousness studies and social enterprise intersect? A unique opportunity, a research institute or lab in conjunction with local or national institutes and research extenstions or initiatives could yield a unique incubation lab.
A place to reflect on ourselves, our place in the universe and our complex neural-cognitive-conscious relationship to our environment Sanitarium for the 21st Century Designed to echo the human experience of the mind itself, this learning center, research complex and park becomes a special place, transcending the sum of its parts: a non-sectarian temple where one can think about being human and our place in the universe. A space for inquiry and imagination, where we contemplate both the limits and the vastness of our capacity to know. The healing of this complex, longvexed, latent-potential, near-downtown compund is a salve for a city, a place, a planet, a people. A solution.
the greening of the ghosts A decent, laudable re-use plan for the former grounds of Central State was set into motion in 2005 when Central Greens, LLC won a city bid to develop the site. Construction for Phase 1 development began in 2012 and continues. The plans call for “new urban neighborhoods that will allow residents to live, work and play all within walking distance,” and will include residential housing, commerical retail, recreation and public green space and education, through preserving some elements of the former hospital in a ‘cultural village.” This mixed-use plan has a little bit of everything and will prove useful. However, had the Central State grounds been seen as a complex, place-based problem—what designers call a ‘wicked problem’—entirely different opportunities might have been identified that capitalized on its uniqueness, creating an original vision, rooted in history, yet pointed toward the 21st century.
The Road Taken
The plan, which formed in 2007 and began implementation in 2012 is described by the development partners as: The Central Greens development will transform the former Central State Hospital into a series of new urban neighborhoods that will allow residents to live, work, and play all within walking distance. Encompassing well designed new retail, residential, recreation and education components, Central Greens will be a major catalyst for the revitalization of the city’s Near West Side. The 150 acre site is one of the last tracts of mostly open land available for development in central Indianapolis. It is strategically located in the heart of the Near West Side neighborhoods, that are home to more than 40,000 residents. The site is 5 minutes away from Downtown and the Central Business District, the main campus of Indiana University - Purdue University Indianapolis (IUPUI), and the International Speedway. At its southern edge is Washington Street, a stretch of the Historic National Road and one of the city’s primary streets.
In other words, it will be a little bit of this and that. Plans do call for inclusion of the historic buildings in a “cultural village,” but the inclusion is not central to the concept; it is a nod to what remains of the past. Meanwhile, the redevelopment is being implemented by premier ex-burb developer, Pedcor of Carmel, Ind. Their cookie-cutter “affordable, market rate” appartments (Phase I, see bleow) are low-end suburban in appearance. New Urbanism is part of the philosophy of this kind of build environment, and, other than
being close to the city, is similar to Carmel Clay and other ‘suburbs with Main Streets.’ While this plan offers a little bit of everything over the land and preserves history, a more holistic, vertically integraded reinterpretation of history--and how it lives on in the present—can come together in a project that incorporates all of the same things, but in an altogether unique way that both highlights the past while advancing our human mission to understand and better manage our brains, our minds, ourselves. By taking more of a risk, digger deeper into history and asking what will be of most use, relevance and creativity for the future, a small cultural gem is preserved while a much larger one is created.
burying the past along with the gem
about this paper A shorter version of this paper was submitted to the Spirit & Place “inspiring Places” Pecha Kucha* contest in 2009. As it turns out, concurrent City plans had begun that same year, and called for redevelopment of the land, featuring sustainable housing in a park-like setting with token homage to history, now known as the Central Greens project. This document nevertheless remains valuable, as a specific (and possibly, in the end, non-competing) idea for redevelopment, as well as an argument for the importance of visioning—for innovation—in the planning process. This paper illustrates how, with a prepared mind, design thinking can lead to creative and inspired ideas that not only make full use of the past and significantly and meaningfully reinterpret the present, but give birth to a new cultural landmark.
Initial Working List of Interested Stakeholders: City of Indianapolis Near Westside CDC & Haughville neighborhood / Quality of Life initiative Indiana Medical History Museum Central Indiana Community Foundation / Inspiring Places Initiative Polis Center / Spirit and Place Festival Indiana University Neurology / Jill Bolte Taylor (author, My Stroke of Insight) IUPUI & IU Health / Stark Institute for Neuroscience Indiana University / psychology and cognitive science Eli Lilly & Co. & Lilly Foundation / neuropharmacology education Lilly Endowment / opportunity of national stature National Association of Mental Illness (NAMI) Mental Health America (MHA) *Pecha Kucha (peh-chach-ka) originated as an event for young designers in Tokyo in 2003 and has since inspired similar events in cities around the world. Pecha Kucha, Japanese for the sound of “chit chat,” provides a format (20 slides, 20 seconds each) for creatives to present ideas and projects to the public. Pecha Kucha Indianapolis, or PK Indy (pkindy.com) formed part of the 2009 “Inspiring Places” theme for the citywide Spirit & Place Festival.
knowledge | transformation | thought leadership amy rubin
vision WHITEPAPER BLUESKY facilitates innovation using knowledge-based and knowledge-building practices and products. WHITEPAPER BLUESKY serves as a change catalyst by partnering with business leaders in visioning, planning and analysis projects that create knowledge, transformation and thought leadership; identifying problems and solutions that match community need with sustainable practices; and promoting a community of critical and creative thinkers as next-generation leaders.
design “Design thinking” is a term used to describe a kind of problem-solving, systems-thinking design. Steve Kelley of Stanford’s Innovation Center, who also help to found the design thinking firm IDEO, coined the term. Design thinking is known to be particularly useful for “wicked problems”— a problem without clear cause and effect relationships and that cannot be “removed from its environment, solved, and returned without effecting its environment.” * *Keith Grint, “Wicked Problems and Clumsy Solutions,” 2008, Clinical Leader, vol. 1, no. 2
Concept Paper: A re-envisioning of the grounds of the former Central State Hospital for the Insane in Indianapolis