CHAPTER VI
IN HOSPITALS CARING FOR THE BLIND
The early plans formulated in the division of special hospitals and physical reconstruction of the Surgeon General's Office, which were unanimously approved by a committee of prominent educators of the blind, were as follows: 1
1. Definition.- Blindness means no vision, or too limited vision to do work for which eyesight is essential.
2. The work in France.-
(a) The establishment of a special hospital center to which all blinded men would be sent.
(b) No soldier to be classed as blind except by the surgeon in charge at this center.
(c) An executive officer at the center, to be responsible for the professional and teaching staff for the blind.
(d) Recreation and occupation for the patient to be inaugurated in the base hospital as early as practicable and continued to the time of debarkation in the United States.
(e) Blinded men should be distributed among other patients to broaden their interests, to secure the assistance of comrades, and to avoid the mutual depression of segregation in a "blind ward."
3. The work in the United States.
(a) At port of debarkation: Continue recreation and occupation under a designated expert. (b) Stations for reeducation:
(1) One or more military stations not far from the eastern seaboard, each to accommodate not to exceed 200 soldiers, with due regard for their proper classification.
(2) A director at each station to be directly responsible for all vocational activities, including the selection of personnel and the determination of the nature and extent of the training to be provided in each case.
(3) Provide suitable instruction in such subjects as the approved uniform embossed system in reading and writing, writing with pencil and typewriter, transcribing from the dictaphone, telephone switchboard operating; in such manual occupations as weaving, woodworking, cement work, netting; in recreations; in physical training through gymnastics, athletics, swimming, bowling, boating, etc.
(4) The director to recommend and secure any additional educational training deemed advisable and accepted by the patient, including college, professional, or intensive training in existing shops or factories.
(c) Placement and follow-up work:
(1) A Federal placement agent to be appointed to ascertain opportunities for the blind, in cooperation with such Government agent as is empowered to make similar surveys for handicapped men; he to assist in procuring such employment.
(2)Prepare the blind soldier to return to his former occupation or one closely allied.
(3) In the case of the helpless blind, to so instruct some member of the family as to enable the blind man to be usefully employed.
(4) Amend civil-service regulations so as to open opportunities for the blind.
(5) Follow-up work under the Medical Department to be continued during the period of compensation payments, in cooperation with the War Risk Insurance Bureau and the American Red Cross.
(6) The use of properly organized and directed volunteer service in providing entertainment and in supplementing the work of the placement agent.
The plans also gave tentative lists of the types of recreations and training to be used, and suggested that the work be initiated at once by commissioning
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two designated men of experience to assume charge of the work, one in this country and one in France. The immediate necessity for a definite policy for the employment of teachers was noted, and the advisability discussed of drawing one or two from each of the leading institutions for the training of the blind. It was also suggested that one or two high-grade instructors in mechanics be employed to study the problems of the blind with the blind, in order to invent simple contrivances which would allow them more successfully to compete in industrial occupations with able-bodied workmen.
Men rendered totally blind presented one of the most difficult of reconstruction problems, in part because of the great initial depression coexisting and often continuing over long periods, and also because of the difficulties surrounding any attempt at reeducation, more especially of direct vocational training.2 It was particularly necessary that these unfortunate men be protected against excessive sympathy on the part of the public, such as would tend further to depress the blind and convince them of the hopelessness of their situation. It was essential that each blind soldier be convinced that he might be happy and useful though blind, and it was felt that the best way to attain this desired end would be to bring him into contact as much as possible with blind persons who had in the largest possible measure overcome their handicap. Indeed, this was true of severe mutilations as well, and it was hoped that, as time went on, a large number of instructors and "cheer-up" workers might be drawn from this class. 2
It was decided to concentrate the work for the blind at one hospital. A private estate of 100 acres in the outskirts of Baltimore , Md. , known as "Evergreen," was loaned to the Government for use as a hospital for the blind. This was taken over on November 15, 1917,3 and organized as General Hospital No. 7 on the 27th of that month.4 The construction of the necessary buildings to supplement those existing was not begun until April, 1918, owing to the congestion of transportation facilities.3Some alterations were also necessary to adapt the existing buildings to hospital purposes. No equipment for physiotherapy was considered necessary. The first patients were received in April, 1918, and there were 105 enrollments during that year.5
RECONSTRUCTION SERVICE, GENERAL HOSPITAL NO. 7
The initial work of the educational department was begun on July 5, 1918 , when the educational director arrived at General Hospital No. 7 to take up the work of reeducation of the blinded soldiers.6 Owing to the fact that the educational buildings were not completed, it was necessary to have sessions in the hospital building known as Evergreen Junior. During the months of July and August there were two reconstruction aides engaged in the work of teaching Braille, typewriting, English, and arithmetic. A physical instructor was employed, and two normal-sighted enlisted men assisted in the educational work. A teacher from the Maryland School for the Blind came several days a week to teach handicrafts.6
Blindness, perhaps more than any other handicap, limited the physical activity of the individual. He was thrown into an entirely new world and needed, as it were, kindergarten training as a preparation for entrance into the
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new sphere of existence. The hand and the ear must take the place of the eyes. The hand especially must be used much more than before blindness, and consequently needs to be trained to distinguish objects and handle them effectively. The education of the blind implied greater individual attention to the pupil than did the education of the normal-sighted. In educational institutions for the young blind the number of teachers must therefore be greater than in institutions for the normal-sighted. But in educational institutions for the young blind one finds for the most part individuals who have become accustomed to their blindness or who have been blinded from birth. In an institution where practically all of the students are newly blinded the need for individual instruction is most evident. In the teaching of typewriting and Braille, for instance, because of the physical and mental condition of the patients at General Hospital No. 7, the instruction was necessarily individual.6 On October 14, 1918 , a schedule having been planned for regular instruction in the fundamental subjects, work was begun in the new group of educational buildings. 6A supervisor of Braille and a supervisor of handicrafts were appointed and organized their respective divisions.6 The greater part of the teaching was done by volunteers who had been trained by experienced workers for the blind. The supervisors themselves were experienced in work for the blind.
The initial work of organizing the educational department having been accomplished, it was evident that the patients would need to be encouraged to undertake the fundamental training. 6 Unfortunately, the patients previously had been told of the wonderful opportunities lying before them of earning large sums of money and of being able to do many things which the blind certainly could not do. These statements had been made to them by individuals who knew relatively little about the blind.6 Consequently, when the suggestion of studying Braille, typewritting, and manual training was made to some of the men they were discouraged at having to start, as it were, at the very beginning of the training, on processes which seemed to be slow in producing results. This produced an antagonistic attitude of the patients toward the civilian instructors, which, however, was soon changed when they learned that their instructors were interested in their welfare.6 The attendance at school improved steadily. At this time there were not more than 12 men in the hospital.
During the month of October a recreational leader was employed who through her ability and untiring efforts, helped to raise the morale of the patients.6 She organized a dancing class under a skilled teacher of the blind. Dances were held regularly. She read aloud to the men, arranged theater parties and automobile rides, and by the beginning of January, 1919, had a well-organized recreational department. Her aim was a high one and one which showed that she understood the blind and that their need was the ability to express themselves-to trust themselves and their impressions.
On November 30, 1918 , there were 30 men enrolled in the educational department.6 The attitude of the men by this time had improved greatly. Men who had at first refused to attend school were attending regularly. Men who had been accustomed to coming late to class were coming before class time and staying after class.
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OUTLINE OF THE WORK
MANUAL TRAINING
The patient's first work was caning a chair. 6 The object of this was to cultivate the touch of the fingers and to teach direction. Caning also had some commercial value, though it was not taught with this end in view. The next operation was netting; each man made a hammock. This brought into play the larger muscles of the hands and was a different operation. Then followed basketry, which was a more advanced form of finger training and allowed of creative work. There was also some simple weaving. Following this came a course in woodworking. The use of tools was taught, and men made such objects as match-box holders, coat hangers, clothes lockers, and stools.
READING AND WRITING BRAILLE
With the loss of sight came the need of learning to read and write with the fingers. This was naturally a slow and nerve-racking process, and the individual was inclined to become discouraged. For that reason the personality of the teacher was of great importance and the need for individual work could be understood. However, men who had objected strenuously to learning Braille had seen the need of such instruction, and under the encouragement of interested workers were then receiving help.6 One of the operations which joined a man in his new life to the sighted world was pencil writing, and when he discovered that by means of a pencil and corrugated paper board he could write to his friends he had made a new step forward and some light had been brought into his world of darkness.6
TYPEWRITING
Typewriting proved to be the most popular study with the men.6 The interest in typewriting was enhanced by the fact that a Corona typewriter was presented to each patient by a woman who was interested in the war blind.6 For this reason all men were taught first to use the Corona typewriter. When they passed the examination given by the supervisor of typewriting they might learn to use some standard machine.
PIANO TUNING
Instruction in piano tuning was begun, but because the length of time needed for training a piano tuner was from two to three years and because there would probably be few of the war blind who would undertake that work the piano tuning was dropped from the course of instruction.6
MASSAGE
One man received instruction in massage and subsequently practiced in the clinic of Johns Hopkins Hospital .6
BOOKBINDING
An expert instructor in bookbinding was employed to discover the capabilities of the blind for this work.6 It was his opinion that the binding of pamphlets in large libraries could be done successfully by the blind.
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ACADEMIC WORK
Instruction in English, arithmetic, spelling, mathematics, Latin, and other academic subjects were given from the time of the inauguration of the work in the educational department. 6
VOCATIONAL INSTRUCTION
A course in salesmanship and personal efficiency was instituted.6 There were classes in poultry raising and agricultural work, courses in woodwork, in factory management, and in auto mechanics.
On December 30, 1918, there were 7 paid teachers, including reconstruction aides, and 32 patients enrolled in educational work.6 The majority of the instructors were individuals of experience and ability who had volunteered their services, but in a few instances, unfortunately, of those in executive positions, their experience was not largely connected with the teaching of the blind nor with military affairs. The schedule of instruction was not entirely satisfactory, in that it was too optimistic along certain lines as to the ability of the reconstructed blind to compete with those not blinded.6 These conditions delayed the establishment of an efficient educational service, and were not corrected until the basic plan for the functioning of the hospital was radically changed and certain changes in personnel made.6
DISCONTINUANCE OF THE MILITARY STATUS OF BLINDED SOLDIERS
Investigations of the conditions indicated that these blinded patients would be benefited by a termination of their military service at as early a date as practicable.6 The psychological reaction of these men in the early stages of this new life which they must lead was radically different from that of the ordinary wounded men, in that the regaining of their independence from the assistance of others at as early a time as possible was of paramount importance, and the idea of military discipline, escorts when away from the buildings, prescribed courses of instruction, etc., engendered a feeling that they were being forced along lines of reconstruction which they would follow with far greater ability and success if they were permitted to feel that they themselves were the main factors in their rehabilitation.7 Therefore, the Surgeon General, early in 1919, recommended to the War Department 7 that all blind patients then in the hospital be discharged from the service at once, and that thereafter blinded patients should be treated in General Hospital No. 2, Fort McHenry, Md., until the maximum amount of physical recovery had been attained, when they should be discharged; and that both classes should be turned over to the Federal Board for Vocational Education for training when discharged; that General Hospital No.7 thereafter should function under the American Red Cross, with cooperation from the Federal Board for Vocational Education and the War Risk Insurance Bureau. That this hospital should be retained as a military organization, but that military supervision should extend only to the maintenance of order and discipline and to the protection of property. That the War Department should turn over to the American Red Cross all the buildings equipment, etc., then in use or requisitioned.
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This policy was approved by direction of the Secretary of War on April 9, 1919.7 Sixty-four patients were discharged from the service on May 22, 1919,S and on May 25, the responsibility for the functioning of the hospital was assumed by the American Red Cross.a
General Hospital No. 7 had a normal capacity of 100 patients. The number of patients in hospital remained below 50 until December, 1918. After that month it remained between 100 and 150 until the hospital was taken over by the American Red Cross.9
REFERENCES
(1) Report on plans for reeducation of the blind, made by Major Bordley, M. C., to Major King, M. C., undated. On file, Historical Division, S. G. O.
(2) Memorandum on physical reconstruction prepared in the division of reconstruction, October 8, 1918. On file, Record Room, S. G. O., 353.91-1.
(3) Report of sanitary inspection of United States Army General Hospital No. 7, Roland Park,Baltimore, Md., December 15, 1918, by Col. W. F. Truby, M. C. On file, Record Room, S. G. O., 721-1 (General Hospital No. 7), K.
(4) Annual Report of General Hospital No. 7 for 1918. On file, Historical Division, S. G. O.
(5) Letter from commanding officer, United States Army General Hospital No. 7, Baltimore, Md., to the Surgeon General, United States Army, Washington, D. C., February 14, 1919. Subject: Physical reconstruction. On file, Record Room, S. G. O., 356 (General Hospital No. 7), K.
(6) Report from acting educational director, United States Army General Hospital No. 7, Baltimore, Md., to commanding officer, April 22, 1919. On file, Record Room, S. G. O., 353.91-1 (General Hospital No. 7), K.
(7) Memorandum, from Assistant Chief of Staff, for the Surgeon General, April 9, 1919. Subject: Treatment of the blind at General Hospital No. 7, Roland Park, Baltimore, Md. (and attached papers). On file, Record Room, S. G. O., 356 (General Hospital No. 7), K.
(8) Report for the week ending May 22, 1919, General Hospital No. 7, by Capt. R. R.. Decker, M. C. On file, Record Room, S. G. O., 353.91-1 (General Hospital No. 7), K.
(9) Prepared from consolidated weekly bed reports of general hospitals. On file, Hospital Division, S. G. O.
a Consult Chapter X, infra, for an account of the activities of the American Red Cross in the aftercare of the blinded .
