Forgotten Buildings, Forgotton Souls

A patient ward in Buffalo State Hospital, closed in 1974.
 copyright, Christopher Payne 

Photographs by Christopher Payne with an essay by Oliver Sacks
(The MIT Press, 209 pages, $39.95)
“Before I began this project in the summer of 2002,” writes Christopher Payne in his extraordinary and extraordinarily moving book of photographs, “I had never visited a state mental hospital.”

“A friend,” he explains, “who knew my interest in forgotten architecture and industrial archeology, told me about one on Long Island he thought might interest me. It was Pilgrim State, the largest facility of its kind in the world when it was built in the 1930s. I drove there and was immediately astounded by its size and dumbfounded by its desolation. . . . I wondered how a place so big, easily larger than any number of towns or major universities, could be so forsaken.”

Between 2002 and 2008, Payne ’90CC visited more than 70 hospitals in 30 states. The vividly exacting and brilliantly selective photographs he made for Asylum: Inside the Closed World of State Mental Hospitals chill by their very beauty and haunt by what is absent: We do not see a single picture of a living human being.

Oliver Sacks provides a splendidly informative and acutely sobering introductory essay to the book. “The first state hospitals,” he tells us, ”were often palatial buildings, with high ceilings, lofty windows, and spacious grounds, providing abundant light, space, and fresh air, along with exercise and a varied diet.”

“Most asylums,” writes Sacks, “were largely self-supporting and grew or raised most of their own food. Patients would work in the fields and dairies, work being considered a central form of therapy for them. . . . Community and companionship, too, were central — indeed vital — for patients who would otherwise be isolated in their obsessions or hallucinations.” 

 Patient Toothbrushes, Hudson River State Hospital
 copyright, Christopher Payne 

These hospitals, invariably built far from populated areas, also offered literal asylum by providing “control and protection for patients, both from their own (perhaps suicidal or homicidal) impulses and from the ridicule, isolation, aggression, or abuse so often visited upon them in the outside world.” By the end of the 19th century, writes Sacks, who is Columbia University Artist and professor of neurology and psychology, state mental facilities had “become bywords for squalor and negligence, and were often run by inept, corrupt, or sadistic bureaucrats.” 

Payne grew up in Boston, and on childhood trips along Interstate 95, he saw Danvers State Hospital “looming in the distance, high on top of a hill. It looked like an ancient, far-away castle, with towers poking above the trees, forming a long string of peaks that hinted of its monumental size.”

There is for Payne, as for Sacks, something utopian about these self-sufficient communities that ultimately, alas, devolved into dystopian dumping grounds. Through his luminous photographs, in both vibrant color and limpid black-and-white, Payne evokes the grandeur of the hospitals, and also their sadness, deterioration, and death. Judicious use of shadow and light, along with a shrewd mix of camera angles that, by turns, induce wonder, awe, claustrophobia, and vertigo, enable us to sense what can no longer be seen: what daily life might have been like in these places for patients, the majority of whom, once they arrived, never left.

Unclaimed Cremation Urns, Oregon State Hospital, OR
copyright, Christopher Payne 
Payne guides us from the majestic, decaying facades of asylums to their innards — from grounds, buildings, and farms to staircases, lobbies, and wards. The ward, he writes, was “the center of patient life . . . the space that best typifies the mental hospitals. 

“The view down the corridor, with its rigid symmetry and procession of identical bedroom doorways, speaks to the monotony of institutional life. In all the hospitals, the wards were fundamentally the same, sharing a plan driven by the need for efficiency and organization. On their own, they are just hallways, but together they are symbols of a closed and isolated world.”
He takes us from rooms where people slept, to the coffinlike tubs in which they bathed; from the bakeries and kitchens where they worked, to the surgical suites where lobotomies and autopsies were performed. We see shoemaking and dressmaking shops, laundries, auditoriums, gymnasiums, baseball fields, beauty salons, TV studios, and bowling alleys, along with subterranean tunnels, heating ducts, and exhaust flues. We travel from asylums that seem, in colorful period postcards, luxurious vacation resorts, to still-life compositions of individual rooms, chairs, beds, and articles of clothing that startle by their stark, serene simplicity. 

Payne selects and arranges tenderly: multicolored straitjackets displayed as if for sale at an elegant boutique; a single hanging straitjacket — crisp, clean, and eerily divorced from its function; a plain wooden box, much like a Joseph Cornell construction, in which dozens of toothbrushes with brightly colored handles hang neatly. A small stack of dirty paper cups on a shelf, stray toothbrushes and toothpaste tubes, and cracked, peeling paint on the wall behind the box remind us that these brushes, paste, and cups once touched the teeth, mouths, and tongues of people we used to call lunatics. 

 Bowling Shoes, Rockland State Hospital, NY

From photos of exteriors that make these institutional complexes seem enchanted worlds, we move to the more and more personal (work, food, clothing), and, at the end of the book, to morgues, stone grave markers (stacked and numbered for future use), cemeteries, and to a storage area filled with floor-to-ceiling shelves of what appear to be glossy, orange-colored cans of paint. We learn, however, that they are unclaimed cremation urns containing the remains of patients.

Payne’s photos evoke the tangible textures of lost worlds and the lost souls who inhabited them — places now inhabited, when inhabited at all, mostly by ghosts. He enables us to see what was too often denied or lost by inspiring us to imagine the individuality and complexity of the people who lived in these places, while also helping us to imagine the helplessness, hope, pain, confusion, and isolation that marked the lives of people for whom such places, whatever else they may have been, were home.


  1. i love old hospitals and prisons. my very favorite places to explore. some seem to be a hybrid of both. most, in fact.

    ghosts abound in them and my son and i can feel small angers in certain areas. or bigger rages in others. it's hard for an empath to enter specific places, like the death row at eastern state pen. my son got really upset, started to shake, and then told me that he would never go where such anger and fear had ever lived.

    isolation, sorrow, fear... emotions which permeate these sites, is hard to navigate when your heart is so open.

    but i choose to bear witness and observe with sober eyes and a broad understanding of the experiences of these places and the persons who inhabited them.

  2. My sister Kathy, sadly, was in Camarillo State Mental for 10 years. It's closed now. Most of the inpatients are the homeless we see trolling the streets with an SSI check in their shaking hands.
    Kathy is in a group home in Escondido, CA.