[Abby marked this article as April 1940, but searching online suggests it was actually printed in April 1941.] Modern Miracle Women
II: Esther Richards Lights the Lamps
Into the dark places of the human mind and down through the bypaths of misunderstood childhood goes Dr. Esther Richards with the lantern of her scientific knowledge and research. Heartening indeed is this story of a pioneer whose fine lifework is human salvage
by Maxine Davis
The rooms are grim and dingy as the hiring halls of a far-from-modern factory. The low ceilings press down with their weight of woe. The long benches sag with men and women sitting with hands taut and eyes fear-haunted.
Until Doctor Richards bounces in. Then suddenly the whole place seems like a meadow after a summer rain. The queer fearful shadows recede; commonplaces emerge defined and dependable.
Tragedy stumbles daily here to Doctor Richards: the tragedy of amorphous clouds and fears and uncertainties. The tragedy of the man who cannot live with himself; the tragedy of the child who cannot play with his companions; of the girl who cannot find one speck of joy in life. The mental and emotional halt, lame and blind come to this, the Phipps Psychiatric Clinic of Johns Hopkins Hospital in Baltimore, because they know that if it is humanly possible Esther Richards will sweep away the cobwebs.
Nothing is so baffling, so frightening, as emotions we cannot understand or control. We see that on the desperate face of the pretty seventeen-year-old girl, a bacteriologist in a big laboratory, here because she has palpitations of the heart; see it in the eyes of the gaunt think-chested lad, a skilled workman in an airplane factory, who has tried to commit suicide; in the child of nine who sits so terribly still beside that woman of fifty-three who has "pains all over" and to whom everything looks green.
They count on Esther Richards to find out what their trouble is and to cure it.
This is a grave responsibility which falls on the shoulders of this small graying woman who heads one of the greatest psychiatric clinics in the country. There is no set of rules for the diagnosis and treatment of sick minds. Doctor Richards' treatment varies with each case, but she has a routine approach to each of her problems. "What is the stuff of which this individual is made?" she asks herself. "What are his intellectual, biologic and temperamental qualities?"
Intelligence tests enable her to estimate with a reasonable degree of accuracy the mental capacity of anyone who comes to her. She finds out that that laboratory technician is a precocious girl; that the boy from the airplane factory has a dull but normal mind. But their biological maturity is more difficult to evaluate. Metabolism tests give a clue, but only a tentative one. And when it comes to estimating their emotional maturity, she has no scientific T-square.
"We all know what emotions are, but our concepts are divided between the theoretical concepts as described in books and practical knowledge of the workings of emotions in our own lives," she'll explain to us. "Fear, hope, love, discontent, bitterness, jealousy and sex urges are the real determinants of intellectual behavior. The intellectual ingredients of our mental life are more or less subservient to these great dynamic forces behind human activity."
Once Doctor Richards has ascertained the intellectual, biologic and temperamental contest of her patients, she tries to find out whether environment, training and educational processes have made this "stuff" better or worse; and what unwholesome combinations precipitated the conditions which have brought them to her office
That seventeen-year-old girl sits across the desk from Esther Richards. "I'm so depressed. I feel there is only one thing to do - die."
That cry comes from the depths. Doctor Richards knows she means it. Here is an intelligent young person, an only child of a comfortable home, who is in profoundest trouble. Someone has secured her a job as technician. It is a responsible job, and although she has been handling it competently, it is too heavy a load. She is the youngest employee in the laboratory, and the only one without a college degree.
Doctor Richards perceives the situation in the space of a breath. An overconscientious girl, this; normally given to worry, to going out to meet trouble and to brooding over her mistakes. The combination of her temperament and the strain of her job has been too much for her. She is in an acute state. The risk of suicide is immediate. Doctor Richards rushes her to a sanatorium at once. She will be in the hospital for two or three months. Afterwards Doctor Richards will help her decide what is the best sort of work for her. She won't be cured, ever. She will have these attacks of depression throughout her life. Doctor Richards will help her and her family to guard against their results.
In comes, then, William L., that lad who has already tried to commit suicide. From his pale, narrow face comes a look of hopelessness heartbreaking in one so young. The report before Doctor Richards informs her that this young man is one of nine children. His mother had married three times, buried each husband, and had tried to keep all her children from breaking home ties. William was in love. He had taken his mother to lunch at the home of the girl. He and the girl had been absent from the parlor for some time. When the mother returned home, she accused her son of serious misbehavior. William went down to the basement, rigged up an elaborate apparatus of beer cases on which to set a big hunting rifle, and shot himself.
Doctor Richards goes to the heart of the matter. "Had you ever tried to shoot yourself before, William?"
"No, ma'am."
"Have you ever tried to shoot your mother?"
"Oh, no, ma'am!"
And then he confides that three weeks after he got out of the hospital, he and the girl were secretly married.
"Where is the gun?" Doctor Richards asks promptly.
There is nothing wrong with this boy - nothing except a possessive mother. Doctor Richards asks him to bring his mother in. She will persuade her to consent to her son's marriage. "Then he'll get out of that house," she tells us.
This case was comparatively simple. But nine-year-old Bobby makes your heart ache. He sits straight and obedient.
"How old are you, Bobby?" asks Doctor Richards. Bobby shrugs. "What grade are you in?" Bobby shrugs again.
He won't count for Doctor Richards, but he isn't stubborn. When she asks him to draw for her, shows him what she wants, he co-operates gladly.
Bobby has a curious speech defect. It is impossible for Doctor Richards to know whether this child is mentally defective or merely very deaf. A child born deaf cannot complain of it, and you cannot use the audiometer until a child is ten. Doctor Richards asks for an audiometer test for Bobby, nevertheless, and as a first measure plans to send him to a school for handicapped children.
Esther Richards is concerned about Bobby. She's intent, too, on the future of Lucy, the tall, thin, tense girl of fifteen, whose mother is in jail for the second time for embezzlement and forgery. Lucy won't look at the doctor. "Nobody can make me believe she did it!" she mumbles of her mother. Lucy refuses to face reality. "And you can't shake a person by the collar and say 'Face reality!'" mourns Esther Richards. "This girl is intelligent. But in facing reality, in distinguishing between the true and the false, we are inclined to think that intelligence is all that is required. Not at all. The emotional urge must be there, too."
A proper environment is Lucy's first need, and Doctor Richards rejects the suggestion that she be put in a boarding school. "It's cruel, because she will always have to explain about her parents. Young girls are regular little inquisitors. This child must be in a private home where she is the only girl in the house." Esther Loring Richards was born near Boston. When she was in college, at Mt. Holyoke, she majored in biology, but she also got A's in English, was editor in chief of the college magazine, played tennis, was Ivy orator, was unanimously voted the wittiest and the most likely to succeed of all her class, and in general gave such evidence of enjoying life that when she wanted to come to Johns Hopkins to medical college, the head of the biology department at Mt. Holyoke would not certify her. Esther did not have the scientific mind; wasn't serious enough! So off she went to the University of Wisconsin for two years, then spent two more years at Johns Hopkins.
Doctor Richards wanted to learn about children, so she went to "School 76" three or four days a week. This was one of Baltimore's first schools to institute programs for the needs of individual children.
"I shall never forget my first years at School 76," she recalls. "The first two were spent in the old building. It was rickety and noisy. After a fire burned it, we dashed in and out of temporary shacks."
"Between lesson periods the boys in one class busied themselves with a great variety of things they took as serious school work. Some acted as errand or messenger boys for the teachers. Some emptied wastebaskets. In the classroom, each child was judged only on whether or not he did the best he could. A great teacher there emphasized the fact that training habits is the supreme goal of education, and it makes little difference whether this habit training takes place through book work or handwork or playground activities. This teacher's boys learned habits that made for good citizenship and for getting along honestly and comfortably in their family lives and in their jobs and their communities."
Here was the beginning of Doctor Richards' special and penetrating interest in children. It is not confined to her office or her clinic. "I've always felt the psychiatrist is not doing his duty unless he puts his shoulder to the wheel."
Doctor Richards today is not only associate professor of psychiatry at Johns Hopkins University, associate psychiatrist at this great hospital, psychiatrist in charge of the outpatient department of Phipps Psychiatric Clinic, lecturer in Public Health Administration in Hopkins' School of Hygiene and Public Health; she is also chief psychiatrist of the psychopathic division of the Baltimore City Hospitals; member of the Advisory Board of the Baltimore Department of Public Welfare, and of about thirty committees of the city and state dealing with educational, medical and psychiatric matters.
She doesn't merely lend an illustrious name to letterheads. She actually works for each institution. How can she do all this? Even when you see Doctor Richards in action, you cannot quite understand. She has a genius for organizing her time. A tiny woman, built like a top, she spins into her office in the clinic at eight-thirty every morning, rushes through her mail; dictates first to one secretary, then to the other; never stops for lunch; never slips a single one of the manifold threads in her fingers.
To look at Doctor Richards is to love her. Her hair is smoothed back. Her eyes are forever a-twinkle behind her spectacles. You wonder at her boundless understanding of the mentally miserable and maladjusted. She has a football player's zest for work. Her wit is glittering but never barbed. When she finishes her day's work, she forgets it. Occasionally, she'll go to her country house and sleep ten hours a night.
Doctor Richards thinks sleep is one of the most important things in life. "Doctors find patients have broken down most frequently because of failure to observe simple habits that have to do with sleep, food and the way they spend their leisure time. The mental life of a person is as seriously affected by lack of rest and sleep as the physical."
Doctor Richards, you see, is a highly practical psychiatrist. She will even advocate a good old-fashioned spanking. "Don't attempt to reason with a small child," she'll advise. "Outline the program and see if he follows it according to his abilities. Beware of arguing for argument's sake. Cut the pattern of training to suit individual child needs."
She believes firmly that every child needs two parents to train him. All too many of those who come to her have only one. Here is ten-year-old Donald:
Donald's mother came to Doctor Richards with the complaint that he was quite beyond his parents' control. The immediate cause for her visit was this: She had told Donald he could not go to play one morning with a neighbor's son. He had said, "Yes, Mother," had left the house and had not returned until four-thirty, when it was time for him to take his place in the family limousine with a group of children his mother had invited to a movie party. That night when she scolded him, he said, "I don't give a damn for you or Daddy, either."
The father was a man who wanted his household free of friction when he came home at night. Donald usually heard a domestic argument if his mother wanted his father to discipline him. Donald's mother made threats she seldom carried out, because when he cried, she weakened. Doctor Richards could not blame small Donald for not swallowing ethical principles from a father and mother who did not love him enough to get together on policies for his training. She had to educate the parents, not the child.
Seven-year-old George's mother brought her son to Doctor Richards because he had "violent attacks of temper, stealing toys and money, drawing vulgar pictures in school. Could it be from pressure on the brain?"
Not at all! George was in tiptop physical condition, and had a mental age of nine years. But four years ago his mother had divorced his father because he was "just too stingy to live with." Mother and son had since lived in boarding-houses, where George was the center of attention. He slept with his mother, sat up as late as she did, and had his first wish gratified. He stole at his first school, and his mother defended him in his presence. At the second school he took a watch, and was transferred to a third. When crossed, he would like on the floor, tear his clothes, scream and spit.
Doctor Richards explained to the mother that George's stealing and lying and tantrums were not trivial matters, but serious antisocial trends which would gain momentum with every year of neglect. She urged her to place the lad in a good school outside the state and to leave him there till he had grown sturdy roots of better behavior reactions.
"Bringing up a child is not a one-parent job, as a great many fathers and mothers seem to think," Doctor Richards says. "The co-operation and active interest of both parents is needed, and while schools cannot take the place of homes in child development, a boarding school or a foster home is better than a family unit where one parent is trying to build up the child while the other merely hovers about."
This lack of family co-operation, together with broken homes, is responsible for many ruined lives when the small victims grown up, she observes.
Doctor Richards' most important contributions in her field have been in her study of children. Perhaps her outstanding discovery is the fact that the intelligence quotient of a child may decline, and that behavioristic difficulties in children confronted with school loads beyond their real ability are defined related to that declining I.Q.
Contrary to the general belief that a child with an intelligence quotient of from 90 to 100 is normal intellectually, that he will always maintain this ratio regardless of whether he was six, ten or fourteen when the test was made, Doctor Richards finds that his intelligence quotient may decline as he goes through school; that when he becomes mature his abilities are perhaps less than normal.
All too many of the misfits of life, of business and industry, are men and women who have been educated beyond their capacity; whose restricted abilities have not been recognized; who try to do work for which they are not mentally equipped, and who consequently fail and even become public burdens.
When such people come to Doctor Richards with "nerves" or depressions or other manifestations of maladjustment, she tries to fit them to their proper niches in life. It is not easy. She is, therefore, a crusader for careful examination a re-examination of children in school, and for intelligent efforts to give them vocational education which will enable them to do a sound job in keeping with their abilities, and to live a satisfying life.
Esther Richards will move heaven and earth to help any human being who needs and can use the assistance science or the community's facilities can offer. But she will not waste time on what she considers "unmodifiable human material."
"When I encounter unmodifiable human material," she says, "such as the constitutional psychopathic personality or the chronic unregenerate alcoholic, the best I can do is try to help those who suffer from his actions.
The constitutional psychopathic personality, according to Doctor Richards' definition, is an individual born constitutionally unable to manage his instincts and emotions and impulses, no matter what the degree of his intelligence. Loeb and Leopold were examples of the constitutional psychopath. There is no way in which society can cope with such people, she believes, unless they commit crimes. "You can never make them over. Under the law, they are sane because they know the difference between right and wrong. According to psychiatry, they have not the ability to act on that knowledge. Parents are often blamed for spoiling children with this disease. Actually, no power can change them."
The alcoholic, on the other hand, is not always "unmodifiable human material." He can be cured, she tells us, if he really wants to be and if he has not deteriorated mentally.
Linger in the Phipps Clinic day after day. Watch Esther Richards in her vigorous care of the tragic figures who come to her. Listen to her teaching medical students and lecturing nurses. You come away from her, and from this house of darkness, knowing that psychiatry is not an obscure science based on remote sex frustrations but a common-sensible lighting of the lamps.