I started my career in health care while in college as a health care aide at one of the three largest public state health care facilities in Virginia. Cells for patients when they were first admitted were very spartan because of the risk that patients would "hang" themselves.

They could not be admitted without an initial "quick evaluation" by the doctor on call at the facility. In some cases, we were required to take their clothing and give them several blankets to use to cover their bodies.

The rooms were padded to prevent patients from injuring themselves, but generally the temperature of the units was between 60-80 degrees depending on the temperature outside. The hospital simply did not have a modern HVAC system, so it could moderate the weather outside not maintain a steady temperature inside. So, it might get cold, but nothing like that described in the article and we could and would issue extra blankets if requested. The blankets were made of a special almost indestructible fabric.

Patients were seen the next day by a doctor and given a full physical exam not unlike a prisoner might receive when entering a prison to minimize the risk of disease spreading through the patient population.

The vast majority of patients were there for the rest of their lives due to brain cognition problems many of which were the product of substance or alcohol abuse, advanced syphilis, or some other untreatable mental health condition.

The majority of patients admitted were discharged within 3 weeks. So, while a small part of the hospital was comprised of the patients "just passing through", the majority of the patient population were there for "life". Many of those there for life, who had a history of violence would be put on powerful medications that kept them in an almost permanent stupor.

How this patient was treated is totally unacceptable, but honestly, state institutions under the best of circumstances are pretty depressing and dehumanizing.

While the article concludes that what happened is an example of man's inhumanity to man and I agree with that statement. There is another story here. If you spend one week among people like "Mitchell", you realize how much substance and alcohol abuse have robbed them of their humanity long before the horrible experience of being confined in a state institution does.

Perhaps some of the worse shifts at the hospital were those in the geriatric unit, where patients were in beds lined up in rows. Most were confined to beds 24 hours a day and had bed sores in spite of efforts to keep changing their position to avoid them. They would spoil their sheets two to three times a night and so I would work with another person changing the sheets for eight straight hours... as soon as you finished with the last patient, it was time to start over again. None of the patients could communicate anymore, they just slept or stared.

I worked at his hospital for two years. And I can see how working at such a place after several years can "turn you cold" to human suffering. I was a newbie aide, so I still tried to cheer patients up, make conversation with those who had been abandoned by the families years ago, bring them some candy on occasion.

I don't think the experience recorded in this post is "common", but I knew many a "Mitchell" working at the hospital (my "home" unit was for the criminally insane). I guess what I am saying is if you know anyone going down the road of substance abuse and can do something, do something. Because once they get to the end of the road, it is "hell on earth" under the best of the circumstances and there is no turning back at some point.