During its seventy-five years of service our library has exemplified at least four important things:—first, as has been shown, that one cannot get such good results from the old desultory method of having a few books on the wards looked after by nurses, or even in a central library run by a stenographer in her spare moments, as from an organized, central library with a trained librarian at its head. Second, that although the business basis is the only successful one, the administration of it should be as simple and free from "red tape" as possible. The nearer a hospital librarian can keep her library to the idea of the private library and the more friendly and personal relations she can establish with the patients the more good she can accomplish. The third point I would make is that unless they are very ill and destructive, books are treated as carefully by the insane as by the users of the public libraries. Last year, out of 8,686 volumes taken out by patients and nurses, only 9 were lost or destroyed, and of these only two were charged to patients. It is the proud boast of one of our head nurses who has under him the next to the most violent and destructive ward on the men's side, that he has had out for his patients over 450 volumes in the last two years, and has not lost or had mutilated one single book!
The fourth and most important lesson we have learned is that the value of a well-selected library can hardly be over-estimated as a therapeutic agent. I do not mean by this that a cure can be effected simply by reading the right books; that of course is absurd. But it is a fact recognized by all psychiatrists and at the basis of the treatment of the insane in all hospitals today, that whatever takes a patient's mind off himself and his own troubles and directs his thoughts into other and more wholesome channels, contributes to his recovery. And when amusement pall, handicrafts tire and golf and tennis are too strenuous, books and pictures will almost always help. It is for this reason that we have to be so careful of the kind of reading, especially of fiction, which we put into the hands of our patients. They must be wholesome stories; anything dealing with suicide or insanity is strictly tabu; also stories which are morbid or would be apt to arouse a morbid train of thought. With these exceptions the insane want and should have the same books which you and I read. Moreover, and I wish I could say this loudly and emphatically enough to be heard over the whole country, the insane are not imbeciles and they are not children, and they resent it when they are treated as such just as much as you or I would. If the old ladies like to reread the stories they loved when they were young, so do old ladies everywhere, but they do not want kindergarten stories. And they are as interested in what is going on in the world and in keeping up with the times as anyone.
About once a week I go to Boston, look over the new books, select the ones I like the looks of and have them sent out "on approval." Every book of fiction is read by me, or if it is distinctly a man's book, by someone of the staff in whose literary judgment I can rely. The books which are kept are then classified and cataloged and either sent directly to some patient or ward where I know they will be appreciated, or else placed on the "new book shelves." Neither staff nor nurses are allowed to have the new books until the patients have read them. The patients come over four evenings a week to the library, the men Mondays and Fridays and the women Wednesdays and Saturdays. Our library consists of two large and very beautiful rooms with open shelves and open fires. Some of the patients roam about and browse among the books, others sit at the tables and look at pictures and magazines, while still others join the ladies of the house who generally sit in the front library in the evening with their fancy-work and the fire. Sometimes we play cards with them.
Besides these four evenings, certain patients are sometimes allowed to come over in the daytime, and the nurses come in at any time of day to get books for some particular patient or for their ward. These "traveling libraries" on the wards are our most successful means of reaching those patients who are too feeble, or too ill, or who lack the initiative to come to the library and select their own books, but who will often get interested in a book which lies on the sitting-room table of their ward.
I am often asked what kind of books aside from fiction the patients call for. I suppose books with pictures would rank first, for patients who are too ill to read will often look at these by the hour. These picture-books comprise art books, of which we have a very fine collection bought and added to each year with money from a bequest to the hospital; Black's travel books; Country Life in America, etc. Next come the nature and out-of-door books; then literature, especially Longfellow, Whittier and Tennyson. History is seldom called for by the patients,—sociology and economics never; yet our nurses, especially our Canadian nurses who want to know about conditions in the States, frequently ask for these, and we have books on all these subjects; for, though our hospital motto is "Patients first," we find that whatever increases the intelligence of the nurses increases their efficiency, and we are glad to have them avail themselves of every opportunity for reading and study.
Frankly humorous books I have learned never to give to a depressed patient, and Miss Carey tells me she has had the same experience. If a patient is much depressed he seems to resent being cheered up if he knows it, and we all have realized in ourselves that unless we are in the mood for it there is nothing in the world so dreary as an avowedly funny story. Neither is there any call for collections like the "International library of famous literature," and the "Library of American literature," and in this matter too, Miss Carey agrees with me. Short stories also are at a discount here. The patients want novels which shall grip and hold their attention in spite of themselves. We all know that the complete librarian is supposed to have an extra sense of intuition, and I think I unconsciously say to myself in selecting books for the patients, "If I felt the way that patient looks as if he felt, what kind of books would I want?" Sometimes, though, one makes mistakes. For instance,—we have one patient, a dear old lady, somewhat prim, a little austere, a typical New England aristocrat of the old school, with whom one immediately associates "Cranford" and "Oldfield" and Mrs. de la Pasture. But this dear lady wants detective stories, if you please, and the more gruesome and bloodier they are the more she revels in them. In her estimation, "The Marathon mystery" and "The Boule cabinet" and "The Mystery of the yellow room" totally eclipse "Down our street" and "Queed" any day.
But while short stories are seldom called for, the "short story in long dresses" and bound by itself, is very popular with patients who are physically weak and unable to hold large volumes or to read very long at a time. I always keep a collection of these little books in a special bookrack so I can lay my hands on them at any moment. They comprise such titles as "Pigs is pigs," "The good Samaritan," "Philosophy Four," "Stickeen," "The perfect tribute," "Songs from Vagabondia," "The friendly craft," etc. Then I have other racks on tables and window shelves which I keep filled with different books, changing them often. And I find that shifting the books on the shelves every little while brings into prominence some which have heretofore been overlooked. In short, I try to keep something new in the library all the time, even if only a new plant or arrangement of flowers, for the patients in a hospital of this sort are very dependent on outside agencies for diversion and interest, and their attention must be caught and held by some means or other.
So much for the reality: now for the dream.
Because the library in our hospital has been such a success, because it has so thoroughly proved its therapeutic value, I dream of the time when one as efficient shall be in every hospital in the country. The fact that ours is a private hospital means that we are not helped by the state; it also means that most of our patients, but by no means all, are on a paying basis; it most emphatically does not mean that we have the monopoly of the educated class. While it is true that there are many illiterates in the state hospitals, it is also true that there are in them thousands of men and women as well educated, as refined, as great lovers of books as those in our private hospital. For the majority, it is the question of money, not of education, which determines a patient's place in the state or the private institution. If our people value our library so highly, what must be their deprivation when because of lack of funds they have to go to state institutions where there are no books and periodicals or at best only a few old ones, never changed and seldom added to.