I. Where Are You Going, Where Have You Been?

Joyce Carol Oates’s iconic short story—which you likely read because basically everybody reads it at some point in school—is about the loss of innocence. It’s also about fantasy versus reality. It’s something your favorite resident blogger (🙋🏻‍♂️) has been thinking about a lot as I looked over the essay dropping today. I actually began it back in May when the last post dropped on May 4th. As I dove back in to tackle it again, it seemed far more relevant to me now.

There’s a particular kind of madness that doesn’t come from inside the mind at all, but from the institutions built to contain it. You realize you’re facing one of them if you’re in a room and you can still see those windows—you know the ones we talk about here—but even if you wanted to jump out of them with great determination and a tremendous amount of desperation, you couldn’t. Even if you’re on the first floor.

Every era has its own version of a sort of ark—the place where society quietly deposits the people it doesn’t want. (Read: dumps them.)

If you’ve been sticking with us since the beginning, or if you’re just now joining and deciding to take a look at the older posts, you know we bounce around dealing with different kinds of shadows. We use the flashlight to help us walk through them, and while we can’t avoid the scars, our humor manages to make the trip just a tad more accessible.

We’ve looked at varying kinds of books tackling these dark spaces. We began with the foundational text for this blog, Lie Down in Darkness, and then moved on to kick up the humor with The Wind-Up Bird Chronicle. From there, we decided to give it a different spin and see what happens when individuals don’t wish to shake the shadows, but actually seek them out, trying to grasp them and hold on as tight as possible—in both Donna Tartt’s The Secret History and John Knowles’s A Separate Piece.

I mentioned in the blog’s opening manifesto that we’d focus primarily on fiction, but I also noted the site was architecturally built to expand. So now we’re taking our first whack at an actual non-fiction work. We leave our last cycle behind and move toward what happens when people either seek out or are dumped into the places where shadows are supposed to be handled.

It’s something that grows even darker, and maybe even more difficult to process: the fact that historically, more often than not, people are just there—and actually dealing with the shadows was never really part of the deal.

II. Noah Only Had to Deal With Actual Animals

We have, of course, been speaking of shadows all along. As long as there have been people who have struggled with them, society has often chosen to just toss them even deeper down into the darkness. Nellie Bly, in her time on Blackwell’s Island, demonstrated in her work Ten Days in a Mad-House that the asylum was nothing more than a cold stone warehouse for inconvenient women. And trust me: society’s thoughts on mental illness haven’t really changed, nor has its ability to help all that much.

Nowadays, the architecture of the hospitals is more elegant, the paperwork is definitely much longer (thank you, insurance companies), and the cruelty is merely more politely phrased. But the logic remains clear, and it hasn’t changed: you just lock the problem away and you call it CARE. (And congratulations on discovering the way I write these blog pieces is through dictation—I’ve never understood why audio always capitalizes CARE, but it’s never seemed more fitting than right here, dripping with irony.)

At its simplest, it’s all about stashing people away, ignoring their needs and necessary assistance, and hoping no one looks too closely at the cracks that are showing.

If you traced the map of American institutional cruelty, you would eventually land in Newark—a city that has spent more than a century trying to outrun its reputation as a place where the unwanted are quietly warehoused. When I was originally drafting this piece in my head, my phonetic way of writing kept trying to turn Newark into an ark, but honestly, that feels more true. Because that’s what these places were: arks. It’s just that they were not built to save people from the flood, but to hide them from the world.

The goal was to load them up and ship them out of sight. It was a repository for the inconvenient, the unwell, the unprotected, and the group that still clearly rings through to everyone: the unprofitable. It was designed to drift just far enough offshore so it was out of sight, ensuring no one ever had to see what was happening on the inside or feel uncomfortable.

III. Good Thing One Woman Decided Not to Stay Quiet

Nellie Bly didn’t just walk onto Blackwell’s Island. She walked directly into a national habit—the American instinct to build a structure, slap the word CARE on the door, and hope the architecture could do the moral labor that the people inside refused to do. The more one reads Bly’s book, the more one realizes the madhouse wasn’t an aberration. It was a blueprint.

The thing about these arks, old or new, is that they all run on the same quiet assumption: once you’re inside, the world simply forgets. Every era has its version—Blackwell’s Island had its own cold quarters, and every generation builds its upgraded model of “out of sight, out of mind.” Which is why Nellie Bly’s decision to walk straight into one of her own accord was extraordinarily brave. Some would say borderline deranged, but in the best possible way.

While the rest of the country was content to let this ark drift, Bly climbed aboard with a notebook, a plan, and a stubborn curiosity—the exact kind of stubbornness institutions hate most, where the passenger actually pays attention. It’s the kind that says, Steer me directly to the problem so I can take notes, not away from it. The kind that screams, Don’t you dare try to hide it from me.

Eventually, every ark gets a passenger who refuses to drift away quietly. Bly walked into Blackwell’s Island with the kind of confidence only a woman pretending to be insane could muster. She didn’t tiptoe in; she marched straight through the front door like someone checking into a hotel with atrocious Yelp reviews about mildew, cockroaches, and the distinct possibility that someone might stab you in the middle of the night.

The rest of the country was content to let these institutions sink into their own rot. But Nellie Bly allowed herself to be swallowed up by it entirely whole just to discover what the belly of the beast looked like. And it turned out to be exactly what one would expect: cold, cruel, and run by people who elevated indifference to a dangerous art form.

IV. Hospitals, Indeed, Do Have Bad Food

Inside Blackwell’s Island, Nellie Bly discovered that CARE was mostly a performance staged for the benefit of men who never bothered to look all that closely. And it wasn’t a pleasant performance either. We’re speaking Shakespeare here—and not the comedies. The food was barely edible, the water was freezing, and the nurses treated the patients with a bitter contempt usually reserved for people who dared to exist inconveniently. What was supposed to be a temporary stay to get your feet under you became a permanent exile—a bother, an afterthought, and, most devastatingly, a designation of being inherently lesser than everyone else.

The whole place ran on the unspoken assumption that women were fragile enough to be locked away, but sturdy enough to survive ice-cold baths, neglect, and starvation rations without complaint. Meanwhile, the men overseeing the institution (natch) remained comfortably distant (naturally), convinced that everyone was perfectly fine—which is historically consistent with how men act when in charge of women’s suffering. Bly didn’t have to write dark satire; the madhouse simply provided it for her.

But the real indictment of Blackwell’s Island wasn’t the cold, the food, or even the nurses. It was the inmates themselves. It was a cast of women who weren’t mad so much as inconvenient—immigrants who didn’t speak English (sounds familiar), wives who talked back (that too), women who cried at the wrong times (yep, still familiar), and women who didn’t cry at the expected, polite times (you get the point).

In other words: the usual suspects.

The madhouse functioned less as a hospital and more as a filing cabinet for any woman who disrupted the fragile egos of the men running the world outside. The joke, of course, was that the women inside were often far saner than the men who put them there. Bly didn’t need to exaggerate a single absurdity; she just jotted down everything she saw.

V. Bob Seger Was Right: Still the Same

What strikes me most about reading Nellie Bly’s account isn’t just the catalogue of cruelties—extensive as they were: the baths, the food, the nurses treating human suffering as a mere inconvenience—but the way the entire system depended on total silence. Blackwell’s Island didn’t need to hide its abuses; it simply needed the world to avert its eyes. And for the most part, the world was all too willing to oblige.

That’s the part that feels most familiar right now, after a two-month vanishing embedded inside a toxic, unendurable seven-month stretch of silence from the healthcare system. Institutions don’t collapse because they’re cruel; they thrive because they’re allowed to be cruel—allowed to exist, allowed to function, and permitted to be completely useless.

Nellie Bly understood this implicitly back then, and I understand it implicitly now. She wasn’t just documenting misery; she was documenting the machinery that makes such misery possible. And once you see the machinery, you can never unsee it. You start noticing the gears everywhere: in hospitals, shelters, psych wards, and insurance companies—every place where the most vulnerable are told to sit down and shut up while administrative paperwork catches up with their “appalling” request for basic humanity.

The most chilling thing as I prepared to update this piece is how much it cuts me to the bone.

VI. Blackwell’s Island Didn’t Die—It Franchised

What makes Nellie Bly’s reporting feel less like history and more like a rerun is how little of it sounds outdated. Swap the 19th-century corsets for paper scrubs, trade the asylum matron for underpaid psych techs running on caffeine and despair, replace the cold baths with cost-saving measures, and congratulations: you’ve successfully recreated half of the psychiatric facilities in this country, complete with modern insurance and an ethically bankrupt healthcare system. The script hasn’t changed since Bly’s time; it’s just a classic show they decided to reboot.

We still have administrators who insist everything is fine from offices they never leave, staff who confuse cruelty with efficiency, and a public perfectly content to believe that suffering becomes dignified if you file the right paperwork. Blackwell’s Island didn’t die; it franchised. And every time I read Bly describing some new indignity, lately I keep thinking: Of course. You betcha. Oh my, yes. Of course they did that. Of course they got away with it.

Institutions don’t evolve; they just learn to animate—or is it laminate?—their excuses.

What Nellie Bly exposed—and what still feels uncomfortably familiar—is that institutions don’t need to be competent to be powerful; they just need to be unchallenged. Blackwell’s Island thrived not because it was well-run, but because no one bothered to check whether it was being run at all. Staff could starve women, freeze them, ignore them, mock them, and call it “treatment,” and the world would politely assume otherwise because the word hospital was printed on the door.

If that sounds harsh, congratulations: you’ve clearly never tried navigating a modern psych ward where the decor is nice, the language is softer, and the cruelty is wrapped in mission statements about compassion. We’ve upgraded the furniture, but certainly not the ethics.

This is why Bly’s work feels less like a historical document and more like a user manual for the present. (And if you’ve been with me since The Bell Jar, you know user manuals have been a bit difficult for me lately.) We still funnel the inconvenient into buildings designed to “help” them walk quietly, hoping they stay out of sight long enough for the rest of us to feel normal. The madhouse never vanished. It just learned to file quarterly reports.

If you think that’s progress, you’re probably the kind of person who believes a fresh coat of paint can fix a collapsing foundation—where you literally scream at the top of your lungs and absolutely no one answers, even when it’s their job to do so.

VII. Sorry, But I’m Really Sick of This Shit

What Nellie Bly ultimately revealed—and what remains this country‘s favorite party trick—is how effortlessly institutions congratulate themselves for solving problems they never intended to fix. Blackwell’s Island had entire committees dedicated to praising their own benevolence while women froze in the hallways. Today, we’ve upgraded to glossy brochures, inspirational posters, and mission statements written by people who have never set foot on the units they oversee—executives sitting in offices where they never pick up the phone to speak to the human beings whose lives their decisions destroy.

It’s the same magic trick with much better lighting: make the suffering disappear by pretending it’s being handled.

If anyone dares to point out the obvious—that institutional rot filters down from the very top—the institution simply smiles, gestures at a leather binder full of “protocols,” and hopes you’re too polite to notice that none of them are actually followed. Long before the rest of us caught on, institutions proved they don’t fear chaos: they fear witnesses. They can survive cruelty, incompetence, starvation rations, freezing baths, and staff who treat human beings like administrative clutter. What they cannot survive is anyone paying attention.

Nellie Bly walked into Blackwell’s Island with nothing but a notebook and the audacity to look directly at what everyone else pretended not to see. More than a century later, the only goddamn thing that’s really changed is the decor. The madhouse has just been rebranded. We don’t call it an asylum anymore. We call it CARE.

And trust me: if that isn’t the funniest, bleakest punchline in American history, I don’t know what is.

VIII. The Rebranding of the Madhouse

So maybe that’s the part that should embarrass us most: not that Blackwell’s Island existed, but that its logic is still alive and well, just wearing a slightly nicer outfit and convincing you it’s better. The system pats itself on the back for “progress,” as if swapping stone walls for drywall counts as moral evolution. We point to a modern hospital and say, Look how humane we are now, while quietly ignoring the understaffed units, the endless waitlists, the insurance denials, and the fluorescent-lit purgatory where people sit as their lives fall apart in real time.

If Bly were alive today, she wouldn’t need to fake insanity to get inside—she’d just need to show up in an ER and say she was having a bad week. The system would handle the rest while a doctor nodded and said, “I’m sorry.”

I’m sorry. A line spoken so often in mental health, but six words that have never meant less.

Because that’s the real punchline, isn’t it? We didn’t dismantle the madhouse. We decentralized it. We spread it across cities, suburbs, insurance networks, and intake forms so no one has to feel guilty about locking people away and ignoring their needs. We just make sure the process is more polite. Instead of cold baths, we have “cost-effective interventions.” Instead of starvation rations, we have “budget constraints.” Instead of matrons with sticks, we have administrators with clipboards—and we keep insisting this is CARE, this is compassion, this is the best we can do.

Nellie Bly saw through the performance in 1887. The only difference now is that the performance has more money and a far better marketing department.

IX. Decentralizing the Madhouse

You can call the crisis line when you need help. The number is plastered across social media, emails, and websites. But nobody tells you what to do when you’re pouring out your heart in the dark and all they do is hang up on you.

Ask me. I know.

And maybe that’s why Nellie Bly’s story still hits like a slap: not because the past was monstrous, but because the present keeps insisting it’s better while quietly recycling the exact same brand of nonsense logic. We’d love to pretend we’ve outgrown the era of locking women away for being inconvenient—emotional, foreign, loud, quiet, or simply living at the wrong volume. But scroll through any modern intake form, sit in any ER waiting room, or try navigating the labyrinth of insurance approvals, and you’ll find the same old categories dressed up in clinical language: non-compliant, difficult, unstable, needs further evaluation. It’s the 21st-century version of hysterical. It’s just been transferred to anyone who is suffering, and now it comes with a billing code.

Progress, apparently, just means learning how to monetize the madhouse.

X. Walking Through the Shadows with a Flashlight

Maybe that’s what Nellie Bly understood long before the rest of us managed to catch up: institutions don’t change because they’re wrong—they change because someone forces them to. She didn’t expose Blackwell’s Island because she believed the system could be redeemed. She exposed it because she knew the only way to make the country look at the shadows was to shove the truth under its nose and refuse to let it look away.

More than a century later, we’re still playing the same game—pretending cruelty becomes compassion if you laminate it, pretending suffering becomes dignified if written in the passive voice, pretending the madhouse is gone because we renamed it.

Bly didn’t buy the illusion. And if we’re honest, neither should we. Neither shall I. Ever.

When talking about Ten Days in a Mad-House, we’re not just speaking about a piece of investigative journalism from 1887. We are once again looking through a window—the very window we keep trying to smash through to escape, or repaint so we can’t see through, or tilt at an angle more flattering to our reflection. Yet it remains exactly the same. Bly didn’t expose a broken system; she exposed a functioning one—a system doing precisely what it was designed to do: hide the people who make society uncomfortable and call it mercy.

Sound familiar?

If that sounds bleak, so be it—because it is. But it’s also funny in that dark, American way: the way we keep insisting we’ve changed while standing in the same room, staring at the same cracks, pretending they’re part of the decor.

Perhaps that’s the real legacy of Bly‘s work and the reforms that followed—not the headlines, not the brief national outrage (notice the word brief), but the uncomfortable truth she forced into the light: institutions don’t become humane on their own. They don’t grow consciences. They don’t wake up one morning and decide to stop hurting people. They change only when someone walks straight into the belly of the beast, takes notes, and refuses to shut up about what they saw.

Nellie Bly did that, and we owe her an immense gratitude—but more importantly, we owe her the fight.

Because more than a century later, the only things we’ve improved are the name and the branding on the building. The madhouse is still here—scattered, disguised, and politely renamed, but still humming with the exact same logic.

And if that doesn’t make you laugh—even a little—then you haven’t been paying attention. We walk through the shadows with a flashlight and mocking humor because that’s just enough to keep us going, no matter the cost or the scars accrued.

If for no other reason, in honor of Nellie Bly—

We sure as hell continue to fight.