The Great Divergence

During Cuba’s first “gilded age” (1909-26), Mazorra experienced a troubling divide from a psychiatric profession in development. Though psychiatrists drew on the hospital’s clinical material, especially a purported epidemic of “Spiritist madness,” to build a case for advancement and face down their professional competition, they often did so on the basis of a convergence with criminology. The resulting estrangement from hospital patients dovetailed with disillusionment outside it, fueled by asylum exposés that cohered in a vision of Mazorra as “Inferno.” But chapter 3 also seeks out the underbelly of the Inferno in the experience of patient captivity during a paradigmatic moment: the dictatorship of Gerardo Machado y Morales (1926-33) and the revolution that overturned it.

Fragments of a Journey to Mazorra

Chapter 2 follows the unlikely pact between U.S. occupying forces and patriotic doctors through its fraying under the auspices of Cuba’s first sovereign government (1902-6) and its revival during another U.S. occupation (1906-9). As public alarm grew over a ballooning institutional population and patient death rate, Mazorra’s status as an icon of a sovereign Cuba increasingly cast doubts on the political health of that nation. Reformers, doctors, and patients all contributed to the project of unpacking what sovereignty would mean for Mazorra and Cuba.

Introduction

Before the days of shock treatment and needles, píldoras and juice, this place in Havana, banana plants outside its windows, housed the infirmed of spirit, the politically incorrect. Every one abandoned here in this place, the house of the incorrigible, lost more than track of time …...

The Repeating Madhouse, from Havana to Miami

After 1959, Cubans who fled the island would also learn to communicate their political views in the language of mental change and distress. Here, Mazorra itself would come back into the picture, when the 1980 Mariel Boatlift quickly turned into a psychiatric problem on both sides, due to the apparent presence of the mentally ill among migrants. By the late 1980s, controversy had also erupted in Miami regarding the alleged commandeering by security officials of several wards at Cuba’s Hospital Psiquiátrico. There, a growing number of voices contended, officials had tortured political dissidents, a charge refuted by hospital psychiatrists. Chapter 7 charts the evolution of both controversies to understand the reverberations of the “manicomio” across the Florida Straits, but also to chart popular understandings and experiences of revolutionary mental change.

The World the Revolution Made

Chapter 6 argues that the project of mental transformation in the service of revolution transpired largely beyond the institution. Imbued with the utopian spirit of social engineering, mental health professionals mobilized to implement their plans for psychological transformation. Nevertheless, as psychiatrists in particular discovered, this was a project that the revolutionary leadership itself planned to direct, and in many cases they were forced to take a backseat to its sui generis reeducation experiments. The end result was the unmistakable politicization of psychological change, as an assemblage of psychiatric concepts, language, and practice imbued official expectations and popular experiences of the revolutionary moment.

Epilogue

The more enlightened our houses are, the more their walls ooze ghosts. —Italo Calvino, The Literature Machine (1987) As history perhaps demanded, scandal would return to the Hospital Psiquiátrico with the force of inevitability postponed. In January 2010, four years after Ordaz passed away, news surfaced that twenty-six patients had passed away over the course of one cold night at the hospital. Two days after exile news blogs and ...

Banishing the Inferno

Chapter 5 traces the renewal of the revolutionary pact to rebuild Mazorra after 1959, this time under the auspices of Dr. Eduardo Bernabé Ordaz, personally selected by Fidel Castro to direct the hospital. This round of reconstruction at the newly baptized Hospital Psiquiátrico de La Habana finally reestablished the unity between hospital and state that had come undone during the preceding decades. Under Ordaz’s leadership, however, broader revolutionary trends and tensions inevitably came to bear, including a conflicted attitude toward patient labor and homosexuality, even as the director’s Catholic faith and anti-Communist disposition established Mazorra as a unique space within the revolutionary project.

The Plague of Politiquería

Chapter 4 examines the implication of Mazorra in Cuba’s great age of corruption, which followed the thwarted 1933 Revolution. As a state institution, Mazorra offers a mirror for the politicking that overtook government during the 1940s and 1950s. Meanwhile, a generation of social reformers pushed to achieve their vision of social engineering in accord with scientific principles, as realized in the 1936 Social Defense Code and the 1940 Constitution. But the professional classes who had agitated for legal change encountered significant obstacles in enacting their programs on an individual scale. Consequently, it would remain for future generations to extend psychiatric expertise beyond the hospital.

A Moral Revolution at Mazorra, 1899–1902

Chapter 1 examines the massive reconstruction effort undertaken at Mazorra at the end of the Cuban independence war. In particular, it examines the collaboration between U.S. occupying forces and Cuban liberating hero Lucas Álvarez Cerice to transform popular outrage over asylum conditions into a popular and patriotic rebuilding effort. Both groups turned Mazorra into a key nationalist icon, even as their efforts to implement a new therapeutic regimen (with particular emphasis on work as treatment) recapitulated racial and class divides.