Louie B. Nunn Center for Oral History

Interview with Frank M. Gaines, October 10, 1983

Louie B. Nunn Center for Oral History, University of Kentucky Libraries
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00:00:00

 KLEBER: The following is a spontaneous and unrehearsed interview with Dr. Frank M. Gaines, and the interview was made in Dr. Gaines' office on Newburgh Road in Louisville, Kentucky on October 10, 1983. The interview was conducted by Dr. John Kleber, Department of History, Morehead State University. Dr. Kleber is Professor of History at Morehead State University. Dr. Gaines, I wonder if you could tell me, what is your current position?

GAINES: I am in the private practice of psychiatry here in Louisville, and I practice with a group of other psychiatrists and have done so ever since I got out of state government some years ago.

KLEBER: Now could you tell me when and where you were born, sir?

GAINES: Yes, I was born in Carrollton, Kentucky, uh, 30 March 1916, and, uh, grew up there for a few years until my father went into the public health service and we moved around a number of times, first to Chicago where he was in 00:01:00a Veteran's Administration hospital and then later we moved back to Kentucky in, uh, where he was stationed at a hospital near Dawson Springs. Now, then and now called Outwood Hospital. By the way, it's now been taken over by the state, but at that time was a veteran's hospital. And then after he retired, he went back to, uh, Carrollton and, uh, lived 'til he died.

KLEBER: Could you tell me your educational background?

GAINES: I--after growing up and going to school in Dawson Springs, Kentucky and graduating from high school there, I then went to the University of Kentucky and graduated, uh, from there in 1937, uh, as a pre-med. Then went on to the University of Louisville Medical School and graduated there in 1941. After this, an internship in, uh, the, uh, medical field hospital in Charleston, South 00:02:00Carolina, then into the armed services. This was the beginning of World War II and I was in the Army, uh, Medical Corps for, uh, a little over three years, serving first with an infantry division and then later with an evacuation hospital in Europe; uh, as a dental and medical officer and then as an anesthesiologist. Then after that, I came back to Louisville and had two years of training in internal medicine, and part of that included a rotation through psychiatry which was normal for all specialists in internal medicine. And this gripped my interest so that I changed to psychiatry, had another year on psychiatry here, and then went on to the, uh, to New York Hospital. Had two years there, and then back to Louisville again for the last year of my training at the Norton Psychiatric Clinic which had just been opened up. Then, uh, I was invited to stay on there as the clinical director of Norton Clinic and was in 00:03:00this position when I was invited to, uh, join state service.

KLEBER: Could you tell me when and where you first met Lawrence Wetherby?

GAINES: As best I can remember, it was the time I was sworn in, in his office. (laughs) I think perhaps a little prologue to that might be of some interest as to how, uh, the person was selected for that position. At that time, the state hospitals were administered within a Divisions of Hospitals and Mental Health in the Department of Welfare. And, uh, the person who had occupied that job held several jobs at one time. Doctor--Dr. A. M. Lyon was the superintendent of the state hospital at, at, uh, Lakeland, and then he, in addition, was given a job as Director of Hospitals in Frankfort, and for a brief time was also Commissioner of Welfare. So, uh, he was obviously doing too many 00:04:00things, so that when, uh, Lawrence Wetherby came in, he asked for nominations for the job as Director of Mental Health and Hospitals. As best I can remember, the law at that time required that at least three names be given to him by the Kentucky Psychiatric Association, so as I found out later on, uh, the, the officers in the Kentucky Psychiatric Association asked Dr. Spafford Ackerly, then the Professor of Psychiatry at the University of Louisville Medical School and also Dr. Billy Keller, who was his associate, to make a selection and they asked if I would do it. Uh, two other names were submitted, but, but I, I had agreed that I would--to do so if selected. So they made the recommendations to the governor. I think you might want to know also the fact that, uh, that 00:05:00Governor Wetherby, prior to his becoming governor, had served on the Board of Directors of the Child Guidance Clinic where he had first known Dr. Ackerly, who then, in addition to being Professor of Psychiatry, was also the, uh, medical director of the Child Guidance Clinic. So, uh, they had had some association that way, and then also, I think they may--he may--Dr. Ackerly may have been a consultant when, uh, the governor was the judge of the juvenile court. Either he was a consultant to the, to Governor Wetherby or he supplied people to help him during this period of time. So they knew one another fairly well, and I think the governor was obviously comfortable in asking Dr. Ackerly and Dr. Keller for a recommendation for this job. So the-- that accounts for the fact that I first met him when--(laughs)--I went up to be sworn in.

KLEBER: Do you happen to know the names of those other two men who were nominated?

00:06:00

GAINES: Yeah, it was one of my present associates, Dr. John Bell, and also Dr. Donald Moore, who at that time was the head of the V.A. Psychiatric Service. Uh, the, uh, other background might be of interest, is that at this point, they were looking for somebody who had some clinical knowledge of psychiatry. Most of the people in the state hospitals in those days-- now there were some exceptions-- but most of the people were physicians who had taken positions in the state hospital but were not specialists in psychiatry by training, so that their intent was to get somebody who did have specialty training, and at that time I was, uh, board certified by the American Board of Psychiatry and Neurology, and there were no others in the system who had that certification as a specialist. Uh, the other thing which they hoped to get, but they were taking a chance on, is somebody who had some administrative experience, and I'd had a 00:07:00little bit in the Army, and, uh--a little bit at the Norton Psychiatric Clinic, but, uh, the primary thing was to get somebody who knew something about clinical psychiatry. So that was the background of my appointment.

KLEBER: When, uh, you first knew Lawrence Wetherby, did you form any early impressions of him, and did those impressions change, uh, over the years that you knew him?

GAINES: Well, as you know, he's a pleasant, gracious person, and that was my first impression of him. And he was most gracious to me and to my wife when I was sworn in. And, uh, that was our relationship all through the time that I, I served in his cabinet. Um, I can remember he--if you recall, "Doc" Beauchamp was lieutenant governor at that point, or became lieutenant governor in the next administration, that's right. At that time, he was in the Department of Highways, and he, uh, Governor Wetherby turned me over to Doc Beauchamp to show 00:08:00me around. And, uh, the reassuring thing, the very first day, Doc Beauchamp, who was the consummate politician, reassured me by saying, "The best thing you can do about politics is to do a good job and do everything you're supposed to do." And, uh, that's the way it was the whole time. And maybe I, I might enlarge on that part, because in looking back through some old records, I was reminded that in those days, there was no merit system. Uh, everybody who was appointed to state government had to be cleared by their county chairman before they could be appointed to a state job. And this was a lowly attendant in a hospital, even. Uh, the governor suspended all of that, and said we could hire people on the basis of merit and he would not interfere, and these people did not have to be cleared by their county chairmen. And this was quite a 00:09:00departure, and raised some hackles locally, I, I had heard. But he stood behind us the whole time and not only did not interfere with hiring and firing, but was of great, uh, uh, back-up support in this regard, um, because the--before this, and also after this, the state hospitals were thrust into, into politics from time to time. But during his entire administration, and, uh, he did not waver from this one whit. And I, I've also laughed, thinking back about this, about the times he might have called me to ask me to do something. And the only time I can ever remember was one time after I'd been in the job about a year, I guess. Uh, the superintendent of the state hospital at Lakeland, called me up and said that it had been, uh, the custom to allow hunters to hunt on the back 00:10:00of the hospital farm during some season, which I forget now. And he thought this was not very safe because we had patients working out on the farm in that area, and so he and I just agreed that we would not allow hunters on the ground. Well--(laughs)--uh, Governor Wetherby, who was a great hunter himself and lived in Anchorage, got all sorts of irate calls from his hunting friends, pleading for us to open up the farm for hunting. But when I explained to him that this was really not very safe to do it, why he stuck by me and backed me up, even--(laughs)--on this which I think took a lot of courage with his friends. Aside from that, I really don't ever remember him calling me and asking me to do anything that even of a personal or anything of a political nature. And this also brings up another anecdote that I remember. Uh, Governor Wetherby had two 00:11:00kinds of cabinet meetings, the political ones and non-political ones. The later--latter were for administrative purposes. And I was never invited to the political ones. He just, uh, there was a certain list of people who were to come to those and then all the commissioners came to the so-called administrative cabinet meetings in which budget, policy, things of that sort were discussed. So, uh, again, I appreciated that. Now I don't--I might have gotten some more gossip if I had been there--(laughs)--to hear those things, but, uh, uh, never was--I mean, it was quite clear that he was making a special distinction because he had a special interest in the mentally ill. I think because of his background on the Child Guidance Clinic in Louisville before he became governor. But this was one of his, uh, uh, planned programs to improve the state hospitals when he came in.

KLEBER: It seems as if he gave you a great deal of autonomy in running the department.

00:12:00

GAINES: A great deal, yes he did.

KLEBER: Um, were you in very close communication with him on a regular basis?

GAINES: Um, in the beginning, yes. Uh, but after that, he pretty much gave me a free hand. Now, if I needed something, uh, I would go to him and ask him. I, I should--I should ask--give you an additional series of anecdotes that led up to the formation of the Department of Mental Health because that did not occur during the first year or two. As you remember, he came in as-- um, when the governor left to go to the Senate, and he succeeded him, and then it was a year, or the next time the legislature met anyway, before any changes were made to create the Department of Mental Health. So that during that first year, approximately, we were a division within the Department of Welfare. Now Luther Goheen was the Commissioner of Welfare during that time, and he was an able administrator. He was a, a social work background, and was a pleasant person to 00:13:00work with. I later found out that the governor, uh, made a kind of test case one time that neither Mr. Goheen nor I knew was coming about until it was all over. Uh, at the end of a certain period, there was--there became some money available for the govern--for the governor to put in the welfare program. He thought that Mr. Goheen would put it in mental health; but Mr. Goheen didn't put it in mental health. He obviously had many demands on him in the prisons and the child welfare program and all that. And, uh, this was no criticism, but I think the governor was trying--(laughs)--to find out where his heart lay so that mental health did not get the money so it--when we approached the governor to create a separate Department of Mental Health, he was, uh, quite agreeable, and 00:14:00then put it on the administration list of bills in the next legislature. Uh, Senator Moloney from Lexington then shepherded these bills through the legislature and it was a--there was no discussion about it particularly except for one item. We had wanted to put in the bill that we--that, that and make it part of the law that we would be stationed in Louisville as part of the Department of Health in the same building. We felt there would be some protection subsequently because the Department of Health was pretty much non-political at that point and we wanted the Department of Mental Health to be under their wing, even though it would have been a separate department administratively. And the governor said that was not a good thing to put in a law, but that he would agree that we would be stationed there if we would want to, to be. So that the, the law went through without any trouble and created a 00:15:00separate administrative unit to administer the state hospitals. Now the one thing they decided that--at that point, was to exclude the, the so-called feeble-minded institute which was then at Frankfort and I--frankly I can't remember why, this many years later. I think it was because of some, uh, pressure from the Department of Welfare feeling they were being--you know, their administrative power was being reduced so that the, uh, the Home for the Retarded was left in the Department of Welfare, although subsequently, about four years later, was moved into the Department of Mental Health after I left, as I think it should have been. Uh, and, uh, and, has been a part of the mental health program since then.

KLEBER: You were head--you were in charge of the Division of Mental Hygiene in 1951, is that correct?

00:16:00

GAINES: I think that's the timing. I forget the exact year, but I believe that's correct.

KLEBER: And-, uh, and then you had an active role in, in formulating the legislation that created the Department of Mental Health in 1952?

GAINES: Yes, that's correct. We had a very small staff in the Division of Mental Hygiene and Hospitals. It included two people that I had recruited, one of whom was, had been in city government in Louisville, and was an attorney and as a matter of fact, he wrote, wrote the law for us, but we had input from a number of people, a great number of people including, uh, some advice from people out of state where they already had departments of mental health.

KLEBER: Why did you feel a separate department was necessary? Why do you think Lawrence Wetherby felt it was necessary?

GAINES: Two reasons. Uh, one, he wanted to give emphasis to this, and I think he felt that if it was separate, uh, administratively that we could 00:17:00emphasize it, and also make it a little clearer in the budget as to what was going to whom. Secondly, I think from his, uh, the, the anecdote that I told you awhile ago, that there was some, uh--that we were sort of playing second fiddle in the Department of, uh, Welfare. Uh, after all, they--the welfare had tremendous responsibilities running the prisons, and the hospitals and the child welfare program. So, um, now this was before the days of Social Security, so they did not have that. That came a little later. But they still ran the, uh the, uh, the orphanage and the, the Home for Delinquent Children. So there was a big responsibility, and I think he wanted it out from under that.

KLEBER: To give it more attention?

GAINES: Right.

KLEBER: Now when the, uh, the Department of Mental Health was created, uh, the penal institutions, the medical hospitals and child welfare remained under the Department of Welfare, is that correct?

GAINES: Yes, that's correct.

KLEBER: Uh, you were approximately thirty-five years old when you, uh, 00:18:00assumed this, uh, responsibility. Uh, were you apprehensive about it? Self-confident? Uh, or is--perhaps you just didn't know any better?

GAINES: (laughs) Well, as I mentioned to a number of people in the past, I think you have to be young and confident to do something of this sort. Um, it obviously was an exciting time and, uh, I must say in retrospect I enjoyed it thoroughly. Um, there were some difficult times obviously, um, but, uh, I don't know that I was over-confident but I do recall that I had tremendous backing not only from the governor, but from the psychiatric community and the medical schools, and the mental health association which was formed about the same time. And also tremendous backing from, uh, Mr. Barry Bingham of the Courier-Journal. 00:19:00They, uh, this was part of their crusade at that time was to improve the state hospital and Mr. Bingham at that same time was also the president of the Kentucky Mental Health Association, so he was a strong backer of all of this. And, uh, uh, a great influence, I think, in those times. And I don't mean that everything that newspaper said about state government or the mental health program was good because they had, there were, there were valid criticisms that they made. But they were reasonable criticisms that-- there were things, many things, wrong obviously.

KLEBER: Can you tell me where your office was located, and the nature of your administrative staff? And your day to day, uh, activities?

GAINES: In that first year, my office was in Frankfort, in the Department of Welfare, and I commuted back and forth from Louisville every day, uh, when I wasn't visiting hospitals themselves. Then after the Department of Mental 00:20:00Health was created, uh, we established an office in the, uh, Department of Health building in the old building which was then on Third Street in Louisville. And, uh, we had a relatively small central office staff by design. We, we did not, uh, money was so tight that we wanted as much of this to go to the hospitals as possible. So the, the staff consisted of three sections: an administrative section headed--headed by what we then called an admin--business administrator; a professional section that was headed by another psychiatrist whom I had recruited, Dr. Dick Jarvis; and, uh, then a-, - a third section which was called the Community, uh, Mental Health section which had been transferred from the Department of Health into the Department of Mental Health. And 00:21:00I--maybe I should diverge and explain that for a moment. Some years before that, the federal government had made small, uh, grants to all the states outpatient psychiatric clinics. That money had been placed in the Department of, of Public Health originally, and Dr. Arthur Casey, a psychiatrist who is-- still living in Louisville, was then the administrator of this. However, when the Department of Mental Health was created, he felt and I felt, and the Commissioner of Health agreed, to transfer that department which--or rather, that division I should say from Health into Mental Health. Now consisted only of a couple of people who administered the federal funds and employed part-time people to go around the state and establish these clinics, and a number of the men who are in private practice now in Louisville and Lexington helped us out during those periods of time. They would, for example, travel to western 00:22:00Kentucky for a day and, uh, establish a clinic and then go back periodically. Well, back again to the administrative set-up, what we were trying to do in the administrative, uh, organization of the Department of Mental Health was twofold: one, was to establish a series of consultants. Uh, now we had me and Dick Jarvis as psychiatrists, and I recruited a psychiatric nurse with a Master's Degree, a master--a social worker with a Master's Degree and to serve on my staff and to then go out and help organize those sections in the mental--in state hospitals. Uh, we didn't--at that time, we did not have very many nurses. As a matter of fact, looking in the old records, we had about eight or ten nurses in four hospitals. Uh, largely-- most of the work was done by aides and 00:23:00attendants. So it was a matter of recruiting new people and training them. Same thing with social workers. Um, now we were trying to do the same thing with people like recreational therapists, occupational therapists, but-- and, uh, we did this in a slightly different way. Uh, I recruited a trained occupational therapist who was then assigned to the state hospital at Lexington, but then she also served as a consultant to me and made--and went around to the other hospitals to help them reorganize their occupational therapy. Same way with recreational therapy. Um, and this worked quite well, because the initial problem we had was to recruit people. There were a lot of other tandem problems as to paying enough money to get 'em to come and get 'em quarters, but the big problem was to get somebody who knew something about psychiatry or psychiatric 00:24:00nursing or psychiatric social work, to get people in the hospitals and treated, and out again. So that was the initial--much to our surprise, when I got into this, I found out that the business administration in all the hospitals was very shaky. These people, in years past, had been political appointees and had really no experience in this. So with the full cooperation of the governor and all the super--medical superintendents, we began to change the business administration set up and I recruited a man who had been in this, uh, in public administration before he'd gotten into our department, uh, by the name of Dick Piatt. And he was a real whirlwind and he recruited people with--and eventually we got, uh, graduates in hospital administration to come and do these jobs. Now we couldn't do that in the beginning because there weren't enough. But as time 00:25:00went on, the business--so-called business administrators had, uh, Master's degrees in hospital administration. And I guess the thing that really startled me and convinced me of the need for this was that early in my tenure, I went out to make a visit at the state hospital at Lakeland, just outside of Louisville. And found out how they were buying anti-convulsants. Uh, now we have a fair number of people, epileptics, and they were buying them by the week retail from a drugstore in Louisville. And obviously a great deal of money. So it was a simple matter--uh, didn't require any great administrative skill to see that the state needed some kind of contract to buy these on a yearly basis for all the hospitals. So that was one of the things we did, a fairly simple thing, uh, was 00:26:00Dick Piatt and his people negotiated with the Department of Finance to-- I've forgotten the word that was used--but a year contract with the drug company to supply us with various kinds of regularly used medications at a much lower cost than we had bought them before. A considerable saving and then we also got drugs that we never used before. Uh, another innovation during this time was that, uh, Piatt also organized a means of collecting, uh, from those patients or their families who were able to pay. We had not means of doing that before. Part of the law, that was changed, enabled us to collect from patients or their families what it cost the state to keep them there. Now the number of people 00:27:00who could pay was relatively small, but the amount of money involved made a considerable difference in what we did collect. So we had a full-time person in our office and also hired full-time people in each of the hospitals to collect that money.

KLEBER: I've often seen Governor Wetherby refer to the self-sufficiency of these institutions, as far as milk and produce and, uh, is concerned. Did that involve you also?

GAINES: Yes, indirectly. My knowledge about farming was--uh, insignificant or it didn't occur--it didn't--I didn't have any, let's put it bluntly. All of the farms, since their early beginnings a hundred years before, had farms by necessity. Uh, there was never enough money, state money, to support the hospitals so they had farms, uh, run by patient labor. Uh, now this was further 00:28:00organized by my business administrator so that we had a farm consultant. Now he also was farm consultant for the prisons and any other farm operation in state government at that time. Uh, man's name, who I forget at this point, but he was a good administrator as well as knowing his business about farming. So he helped select people who could run the farms efficiently. The, there were--I do recall this, that we had dairies at all these farms and it was a real headache getting clean milk, and I can remember--(laughs)--many devoting my time, which--one who knew nothing about this, trying to know how we were gonna get clean milk to give our patients. So what we did, the governor allowed us to establish a first class dairy at the state hospital in Danville and closed the other ones, and then we got into the transportation business of carrying the 00:29:00milk to the other hospitals. So you can see administratively there were a number of things that I never dreamed about when I--(laughs)--went into this.

KLEBER: If you had your, uh, choice, would you have closed down those farms, and are they still working today by the way?

GAINES: They, they were gradually, uh, closed down for several reasons. Uh, the first reason was that in--during the latter part of our--my tenure, IBM came to Lexington and the area they wanted to build their plant was on the farm next to the state hospital. So the governor said by all means, and we gave up the farm with the understanding that our, our budget would be increased to take care of that. The other thing is that, as we got better about treating patients and getting them out more quickly, uh, we didn't keep patients as long. I was flabbergasted to find out when I first went to the hospitals that some people, 00:30:00some patients, were actually being held onto because they were doing jobs in the hospital that helped run it. Uh, I can remember asking about one particular man and, and the business man said, "My gosh, he can't go; he runs--helps run the maintenance plant." And well obviously this couldn't go on, so the same thing was true of the farm. Many early people who were in the hospitals were farmers and knew what they were doing. And, then we gradually, you know, as farming decreased in Kentucky, and more people lived in towns and cities, we had fewer people who knew anything about farming. So gradually they were phased out. Now some of this occurred after I left, but--and it was a gradual thing, and I think in the long run, was a good thing. Um, this brings up another change which we tried to effect. Uh, everybody, as they improved in the hospital, I mean the 00:31:00patients, as they improved, were given duties and there was nothing wrong with this. Simple things, like making their beds or cleaning their rooms or eventually working in the halls and cleaning up. But then as they were given more responsibilities like working on the farm or in the maintenance plant, and uh, they were doing full-term eight hour a day jobs, and, uh, yet some of them were not well enough to go back to their homes, so that what evolved eventually was a, a change in the law later on to authorize us to pay them a small amount of money if they were doing some kind of productive job in the hospital. And this also gave them a chance to get a little money to help them once they were discharged. But again, these were the kinds of things that we discovered as we went along, had to be changed.

KLEBER: I wonder if we could talk just a minute about the treatment of mental patients in the early 1950's. In 1951, Governor Wetherby said that state mental 00:32:00institutions had expanded in facilities, but fallen behind in treatment. And he seemed to be very much in favor of a treatment program to return patients home. In fact, on a--in a speech on July 24, 1951, he said, uh that we-- he was going to "-- use the hospitals , uh, which would afford care and rehabilitation to those patients amenable to medical treatment, we shall not spare time, effort, or available resources in carrying out the human--this humanitarian mission." Uh, can you tell me what were the significant changes before and after that in the Wetherby administration?

GAINES: The--I think the big change was that we'd got some trained people, psychiatrists, nurses, social workers, all the rest that I mentioned previously who knew about modern treatment at that point. For example, uh, in those days, we were giving a good deal of electric stimulating therapy, and---but they--it was not used in hospitals before that and we introduced that. Uh, in those 00:33:00days, we were also using what was called insulin sub-coma therapy for the treatment of schizophrenia and this was introduced during this time. Um, during--about a year or two after I came into state government, uh, Thorazine was introduced in the United States from France and the--we immediately went to the governor and told him we did not have any money to buy these--this new fairly expensive drug, uh, and he made a sizeable contribution--allotment, I guess is the word, to our budget specifically to, to buy those drugs during that year. And this was the turn-around in state hospital populations. Now it occurred all over the United States. Um, but that was the year that, for the 00:34:00first time in history, that state hospital census' began to be reduced. I, I was looking through some old records and for the very first time, I think it was--I don't remember, '53, '54, uh, it--the total state population was a hundred less than it had been the year before that, and that had never occurred before. And I think that's directly responsible to the, the introduction of the, of the revolutionary anti-psychotic drugs at that time. Uh, now the other thing was--two other things, account for this. One was the beginning of a system of getting patients out of the hospital. In years gone by, if you sent a person to the state hospital, the family assumed they'd be there for the rest of their life, and sometimes they were because their--the treatment was negligible, they were chronically ill, and they just stayed there. Sometimes for always. Um, so that we had to make plans as to how to get these people back to their 00:35:00hou--to their families or if they had no families to get them someplace else. And this was the social worker's job which they began to work out. And they also began to work with other agencies in through the state to try to place these people elsewhere and that has continued to be true over the years. The other problem at those times was that we had hundreds and hundreds of elderly, senile patients, who did not necessarily need to be in a state hospital, who had no place else to go. Now I, I suppose this is not exactly treatment, but it certainly is a matter of disposition of these people and taking care of them in an area such as a nursing home rather than in a state psychiatric hospital. Those were exciting times because we really were able to do something that had not been done before in the state hospital.

KLEBER: Do you think that, uh, the practices have continued in the last 00:36:00thirty years that you started then, or have there been any drastic departures from those practices?

GAINES: Oh, I think for the most part, things have continued. Now, those--treatments in those days have changed because there have been newer treatments. But, uh, uh, yes, those things have continued.

KLEBER: Let me talk a minute about budgets. Um, according to the figures I have here, in 1950-1951, the Department of Welfare budget was six million dollars. Uh, you indicated that in 1951, a special appropriation of one million was given to the Department of Welfare in extraordinary session of the General Assembly. Now most of that did go for purposes other than mental health, is that, uh--

GAINES: As I remember, yeah.

KLEBER: Now what about the budgets, uh, 1952 and 1954, and what's your impression of the--of the amount that was given to you?

GAINES: You know, I, I looked at some of those old figures and I can't remember clearly, but I do remember the, uh, the general problem. I think the 00:37:00first thing that we were struck with shortly after we came--went in, was a need to reduce our budget, and I think that was the first year or so, and this was catastrophic because we, not only were we not able to do new things but we had to cut some things we were doing. And--but everybody in state government had to do this. It was a percentage thing. But I can remember with what anxiety we approached this. Then, in the next two, uh, legislative budgets, we got considerably more money. We obviously didn't get as much as we thought we needed, but I suppose nobody ever does. Uh, but enough that we could start these new treatment programs that I mentioned to you, and improve things like building maintenance, and fire safety and improve the food and, uh, a number of 00:38:00things like this. I should say parenthetically, that we did not emphasize buildings during this period of time. We later recommenda--recommended that some new buildings be built, and Governor Wetherby did start the ball on these, but during this time, uh, because of past times, buildings were apt to be in bad repair. Now if you had some, if you had enough left--a limited amount of money and you had to feed people, then you fed 'em and if a window had to be repaired, you put it off. But finally, uh, the, uh, fire prevention people got after us, rightly, and we spent a fair amount of money in repairing buildings so that they were safer. And, uh, and, uh, and so that that, that was not a prominent part of our budget. What we were trying to do was primarily start new training 00:39:00programs and new recruitment programs. I might add this that part of that new money was to go into training programs. For example, we started a, uh, student nurse affiliation at Central State Hospital so that student nurses from the local hospitals came out there for their psychiatric training. And of course, we were able to recruit some of them after they finished their training. We started a school for practical nurses down at the Danville State Hospital which was really, uh, an innovation. You see, we had great trouble getting registered nurses, uh, particularly registered nurses who had any experience in psychiatry. So what we were gonna do is to start a school for licenses practical nurses where they could get their certificate in one year, and then what we hoped to do is to recruit most if not all of these people to stay in state hospitals and we 00:40:00did. This, this was a great help in increasing the number of professional nurses.

KLEBER: In 1954, Governor Wetherby asked for an increase in appropriations from the state legislature by placing what were called "sin" taxes, and you may remember those were on pari-mutuel betting--

GAINES: Oh yes.

KLEBER: -- and liquor and, and so there must have been an increase of revenue then. So I would think that 1954 and '55 must have seen an increase of your budget over '52-'53.

GAINES: Yes, that's true.

KLEBER: Um, you didn't happen to favor a sales tax at that time, did you?

GAINES: (laughs) That was a hot one during those times, as you, as you I'm sure you know from the records. I can't really remember what I thought about it personally, but state government was so strapped for money that I--that obviously there needed to be some kind of increase in taxes. Uh, I think all you needed to do was to go in a state hospital cafeteria when people were going through a meal--I mean the patients were going through the cafeteria line to see 00:41:00what meager, uh, meals they had. Now, they got enough to eat, but it was, it was sometimes sad commentary on how much money we had to spend.

KLEBER: Yeah. Are these the hospitals that you worked with at that time? Let's see if I have them correct: Western State Hospital, which was in Hopkinsville, the Eastern State Hospital in Lexington, the Central State Hospital at Lakeland, the Kentucky State Hospital in Danville, and then I have the Kentucky Training Home in Frankfort. Are those the institutions?

GAINES: Well, the Kentucky Training Home remained with the Department of Welfare.

KLEBER: Which you were talking about earlier.

GAINES: The other four were hospitals that we were dealing with. All of them huge places. Uh, at one time, Central State Hospital had two thousand five hundred patients, so you can see that it was a small city in itself, and if you just think about it, all of those patients were seriously mentally ill. Uh, the 00:42:00others were smaller. As I recall, the one at Danville was the smallest, but still it had over a thousand patients. At one time, as I recall, we had an excess of seven thousand patients in state hospitals. Now fortunately as I mentioned earlier, these gradually went down, and, and, uh, they--and that's no longer true. State hospitals nowadays have a hundred to two hundred patients each, rather than thousands.

KLEBER: Were they overcrowded?

GAINES: Oh, terribly. Um, that was one of the things that Mr. Bingham's newspapers got on us about and really helped us in the long run. They ran articles and showed pictures of how beds were actually jammed together. They, they were so jammed together that it--the patients had to get in bed by crawling over the foot. They couldn't get in from the side. So it was, it was terribly crowded. And, uh, the problem was there were so many patients that it was overwhelming to the staff.

KLEBER: Did Governor Wetherby ever visit any of those institutions?

00:43:00

GAINES: Yes, he did from time to time. And, uh, 'course he had visited them even before he became governor 'cause he had grown up, as you know, in, in Anchorage near where Central State Hospital was, and had known about it during his earlier years. So he was cognizant of the kinds of problems they had.

KLEBER: I'm sure that in the early 50's, all of these institutions were segregated, and that brings up the question of, of, of the psychiatric help for black patients. Could you tell me something about that?

GAINES: You know, I haven't thought about that in a long time, because it was during those years that the desegregation movement came about. Yes, all the hospitals had segregated wards for blacks and, uh, we had, uh, black staff to take care of them. We tried to even, uh, recruit black physicians, although 00:44:00that was more difficult because there were very few available. Uh, and I, I think the black patient got short shrift unfortunately during this period of time. The, which brings up a, a lateral thing which I will get into and then come to this in a minute. One of the other big problems we had during those early years was a, uh, was tuberculosis among the patients in the state hospital. Now as you remember, in those days, the state tuberculosis hospitals were just--were first funded and built and staffed. Uh, but at the same time, uh, er--tuberculosis was endemic in Kentucky so that we had many active tuberculosis patients come into our hospital and then, because of the crowding and the sh--uh, it spread within the hospital. Well, this was an untenable 00:45:00thing. So what we, what we did was establish a separate tuberculosis ward in each hospital. Then later, as the census went down, we were able to, uh, shift some of these-- the better patients to the state tuberculosis hospitals for treatment. But we did recruit physicians who knew something about the treatment of tuberculosis and I did this through the state tuberculosis commission, and the director of-- the medical director of that unit was most helpful in getting, in helping us to deal with it. Um, now let me get back to this, the black segregation because there were several kinds of segregation as you can tell, for physical illness and tuberculosis and, and blackness--

[Tape 1, side 1 ends; tape 1, side 2 begins.]

GAINES: There was great concern when we began to talk about desegregating hospitals. And of course when it happened, nothing happened. It was--went 00:46:00quietly and really was an advantage in the long run because I think we were able to then get the black patients better quarters than they had had before. And, uh, there was never any problem. Anything else along this line that you can think of--

KLEBER: Governor Wetherby at one time wrote a letter in which he was concerned about the treatment of some black patients at, at Hazelwood Sanitarium, I believe it was. Is that the name of it, Hazelwood?

GAINES: Yes, that was a tuberculosis sanitarium.

KLEBER: Tuberculosis center. And he was saying that, uh, black patients had said they had not received the correct treatment and he asked for an investigation into this. Do you feel he was concerned? Uh, did he ever make this statement to you, that he was concerned about the treatment of black mental patients?

GAINES: I don't recall our discussing this. I, I, I know that he came out publicly during the desegregation, uh, uh, thing and, uh, took a stand on it 00:47:00which I thought was very courageous at the time. And, uh, but he never discussed this with me because we went about it in as quiet a way as we could. Not to stir hackles and really had no problem when it finally came about.

KLEBER: Did white doctors treat black mental patients?

GAINES: Yes.

KLEBER: Yes, but you kept them separate in each one of the, uh, institutions?

GAINES: That's correct.

KLEBER: Separate wards. Did you have any personal feelings on that? Uh, how did you feel about it?

GAINES: No, I really didn't. I, I part of my growing up process was in Chicago where I went to school with black youngsters, and so that I perhaps had fewer such feelings as perhaps some other Kentuckians who had not experienced this. Uh, we you know I, I did not run across this in my notes as I read them over before this, and I don't recall any really strong feelings about it. I'm sure there must have been some, but they, they did not surface.

00:48:00

KLEBER: Did the 1952 Hospital Inspection Act apply to the mental hospitals?

GAINES: Can't remember. I don't recall. Uh, now we, we did have inspections by the Joint Commission on Accreditation of Hospitals, and we consistently flunked those exams--(laughs)--because we were so bad, in the beginning. Um, but they were--they were helpful. I mean, the inspectors were helpful and gave us suggestions. Beyond this, I can't recall the other inspection act.

KLEBER: Well, Wetherby pushed that through the 1952 General Assembly, and I have a feeling it probably only applied to medical hospitals.

GAINES: It probably did at that point. I, I don't recall, uh, that being a problem. Now, um, I do, I do recall that the Joint Commission came and inspected us because-- partly because we had started training programs in the 00:49:00hospitals. You see, we not only had student nurses, but at that time we also had residents, uh, in psychiatry and medical school students come out to the state hospital for their psychiatric training. This was through an arrangement between Central State Hospital and the medical school and, uh, this was a great boost to us. I, I didn't mention awhile ago, that with some of that new money that we got in subsequent budgets, we, we were able to establish some scholarships for nurses, physicians, and social workers, with the idea that we would help finance their education and then they'd come and work for us afterwards. And we were able to get some fully trained psychiatrists through this route.

KLEBER: How did you work with the other commissioners that Lawrence Wetherby had around him at that time?

GAINES: I found out that they were a congenial group. It really was. I had 00:50:00no problems with them. Uh, we, we worked together primarily I guess with the Department of Finance, uh, with budget and also personnel because I remember personnel was in finance at that time. And, uh, they were most cordial. They tried to help. Uh, I can remember the budget director was Felix Joyner, who was a great a tower of strength in the administration, and later I think became Commissioner of Finance. And he was a personal friend and, uh, and a, uh, great supporter of ours. Now we didn't get to do everything we wanted to do, but, but he was, he was most helpful. I had less contact with other commissioners, but they were uniformly trying to help.

KLEBER: Was there animosity, uh, envy, jealousy among the various departments in fighting for what was--must have been a very limited budget at the time?

00:51:00

GAINES: If so, I didn't know about it. Uh, everybody was trying to get as much money as they could for their program obviously, and that was understood. And, and the pressure was on the governor to make those choices as to where he would put scarce money. And of course we--he did, uh, did give us money, uh, each, each time he could. If that bothered other commissioners, they didn't tell me.

KLEBER: And you think the governor was, uh, he was satisfied with the amount of money he found for you and gave to you?

GAINES: Oh, the administrator is never--(both laugh)--satisfied, but we were--

KLEBER: But you knew he was doing his best?

GAINES: Yes, he was doing the best he could, and leaned over backwards to fund those things which we knew we had to do.

KLEBER: Um-hm. Governor Wetherby keeps referring to you as "the bright young man" in his administration. Some of those commissioners had to be old political cronies. I know they were. They came out of a different background. They, uh, came out of a rough and tumble school of fighting, but you say you still got 00:52:00along well with them and, uh, that you learned from them.

GAINES: Well, yes, the thing I learned besides the, the anecdote I told about Doc Beauchamp, even those men who were, had come up through the political ranks had a way about them of getting along with people. Now I assume that's, you know, that's the common denominator in politics. But I think I learned from them how to deal with some of the people who inevitably made complaints to state government. Uh, they, I don't see them as slick operators, but as people who were trying to help other people. And their way of doing it, through state government, uh, was a valid way. Now, uh, I have some theories about that in terms of who gets into state government, and who runs for office, and I'm sure it's because of an exercise in power, but the people who were, who were at this 00:53:00level, uh, although they did exercise power in their departments, were also trying to do a job for themselves and for the governor. There was another group of people during that time that had just come into government, and I liked Felix Joyner and the other people who came up through, uh, the--their education in public administration. Uh, I can't remember how many, but I do recall that Mr. Joyner, uh, brought in a lot of young men as budget analysts who then later went laterally in other departments as administrators and are--some of 'em are still around in state government or in universities as administrators. I still see them from time to time, even now. So, this was, uh, this was an innovation. These were not all, uh, political appointees as such, but,uh, these were career administrators.

KLEBER: Bert Combs had said that Lawrence Wetherby's administration probably 00:54:00was just that: an innovative administration that set us on the course of a modern Kentucky, propelling us almost for the first time into the twentieth century. Do you see it as something like that?

GAINES: I guess it's a little difficult for me to see it in that breath, as I'm sure Governor Combs can. But yes, there was no question about it, although, uh, Lawrence Wetherby is not seen as an innovative person who--publicly.

KLEBER: Um-hm.

GAINES: There's no question that, from the standpoint of running state government, he was. And, uh, uh, well, some of these things fell apart later on, but there was no question that this was a start of a great change.

KLEBER: Did the, uh, Hill-Burton Act affect mental hospitals?

GAINES: Yes, to some extent. We tried hard to get money from them, and of course they had limited funds too, and this was during the time that a number of small hospitals were being funded throughout the state in rural areas, so that 00:55:00the first choice went to them. But we did get some Hill-Burton money to, for new buildings. For example, the one I remember best was a new treatment center over at Eastern State Hospital which was eventually completed after I left, but we, we got the beginnings of that from, uh, from that era.

KLEBER: Could you distinguish for me your professional relationship to Lawrence Wetherby and your private relationship to him?

GAINES: Um, professionally, he was--as I mentioned before, supportive, encouraging, gave a hands-off, uh, leeway for us to do what he--what we wanted to do and needed to do, and he was very supportive. Um, as I mentioned to you, he never called up and asked me to do things that I would not have wanted to do 00:56:00politically, ever. Um, one time during a, uh, one of the subsequent, uh, campaigns for governor, one of the governor's candidates made some disparaging remarks about the state hospitals, and he publicly discounted this and supported us on that score. Um, there were times--I also ran across some of my old minutes about, uh, Grand Jury investigations about the hospital, both in Louisville and Lexington, and some of these criticisms were valid, but he was supportive in this. And, uh, both, both publicly in the newspaper and also in providing money later on to try to correct the, those things that were criticized. As far as my personal relationship with him, it was fairly formal. Uh, he was always friendly and, and nice. And he would, uh, uh-oh it just, I 00:57:00just remembered something just then. Uh, he invited me to a couple of varmint suppers. I'm sure you heard about these. I didn't know they existed, but I went to two of 'em, and they were great fun. Uh, one of these was at a state park down in western Kentucky and an, an old classmate of mine from high school, who then worked in the governor's office, whose name was Mack Sisk, uh, organized these. As a matter of fact, Mack was a cook himself and helped prepare some of the varmints. And for the first time, I ate things like 'coon and, and other exotic things that I'd never eaten before or since. Uh, the other recollection I have on a personal basis is that my wife and I had never attur--attended the Derby even though we lived in, in, uh, Louisville all these years. And he called me up quietly about three or four days before the Derby 00:58:00and asked if I would like to have tickets, that he had been given some as governor, and he was giving these to some of the people in his administration. So for the first time in our life, we went and saw the Derby in a box. Uh, he was gracious in inviting us to several social functions at the mansion, and I met his wife and she was equally gracious in her relationship to me and my wife. So it was pleasant that way although we did not know him personally otherwise outside--

KLEBER: No hunting or fishing with him?

GAINES: (laughs) No hunting or fishing.

KLEBER: In 1955, as you well know, there was a very bitter primary campaign.

GAINES: Oh--

KLEBER: Between Bert Combs and "Happy" Chandler, and, uh, were you involved in that primary campaign at all?

GAINES: No, not at all. And again, that was, that was the un--unspoken 00:59:00agreement, that I would not be involved in any of this.

KLEBER: Now when, uh, Governor Combs, uh, lost that primary and Chandler went on to, to win the governorship, uh, you were not reappointed as,uh, a commissioner.

GAINES: As a matter of fact, I was.

KLEBER: You were? Oh, okay this is kind of--I didn't know that.

GAINES: Um, I was the only carry-over from the, from the Wetherby to the Chandler administration, and this was kind of an interesting thing because we were aghast feeling that all we'd done would fall apart, both medically and administratively. Uh, I can't remember the exact sequence of events, but, uh, about I guess a month--at least two to three weeks anyway, before Governor, uh, Chandler was to be inaugurated, Mr. Joe Leary called me up on the phone and asked if I'd come over to talk to him in Frankfort. As you recall, our office 01:00:00was in, in Louisville. So I drove over and met with him in his law office. Now, for those who may not remember, Mr. Leary was a, a supporter of Mr. Chandler and I think may have had a part in his campaign. I don't remember the details. Mr. Leary was, was very nice and very cordial and asked if I would be willing to continue in Mr. Chandler's campaign, I'm sorry, in his, in his administration. And, uh, I had heard rumors of this by phone that I would be invited, so I thought about it and I told him that I would under certain circumstances, namely if I would be able to continue to have the staff that I had gathered together, and also if we could continue our relationship with the hospitals--I'm sorry, with the medical schools at that time, because I also had an appointment at the medical school in the department of psychiatry as a faculty member. And he said he didn't think that would be any problem. Um so, 01:01:00again, I had never met Governor Chandler before then until the day I was sworn in, and there was a funny incident about this. Uh, since I was essentially an outsider to them, uh, I was simply told to appear to be sworn in, in the governor's office, following the inauguration. And so I went to the door and the door was locked and I-- there was a crowd around there waiting to get in of hangers-on, and finally somebody came to the door after much knocking, and I identified myself and then I found out that they were in the process of changing the locks because, so that they would have their own keys to get in the governor's office, which I understand is standard procedure whenever one governor succeeds another. (laughs) So I had--(laughs)--had a problem with actually getting in the door. Uh, so I did go in and was sworn in with the 01:02:00other Cabinet members.

KLEBER: What was Governor Wetherby's reaction when you told him you were going into the Chandler administration?

GAINES: He was very supportive and encouraged me to do so. I discussed it with him, and he hoped I would, and wrote me a very nice letter on the last day in office about this, which I have among some of my old papers.

KLEBER: Did you stay on through the whole Chandler administration?

GAINES: No, I lasted about a year.

KLEBER: I have you, 1955 to '57 as Chairman of the Council on Mental Health Training and Research of the Southern Regional Board. Is that correct?

GAINES: Yes. Now, that was, that was during the last year that I was in state government, and part of this was in the Chandler administration. That's another thing which we might talk about a little bit, because this was an innovation that Governor Wetherby took part in. The southern governors set up the Southern Regional Education Board, as you know, and one of their projects was in mental health because all of the states--well all of the states, the 01:03:00southern states in particular, had great problems in staffing and running their state hospitals. So a survey was made by the SREB, uh, and a representative from each staf--each state was on the survey committee and I represented Kentucky on it. Incidentally, also, the representative from Alabama was then Judge George Wallace, uh, and I got to know him a little bit during this time, but we also--it was a mixture of political people, mental health professionals, other professionals, some from outside the region, to make a survey of what we actually had and what we needed. After this was completed and was presented to the Southern Governors Conference, they directed that a special unit called the 01:04:00Mental Health Unit of this SREB be set up and I was the first chairman of the board of, of this, uh, of this mental health unit. And that for the most part, had representatives from the state hospital systems throughout the south. And the things we tried to do and began to do, and still are doing, by the way, is to encourage, uh, joint educational efforts. Uh, for example, the first one I recall was that, uh, it was decided in Kentucky that we would not establish a school of veterinary medicine, that our veterinary students we would send down to an already established veterinary schools in Alabama I think it was.

KLEBER: Auburn?

GAINES: Um-hm. And similar--similarly, in the mental health field, we established, uh, training programs in psychiatry, social work, and other things of that sort, and also nursing, uh, which, uh, which we could, uh then send our 01:05:00students or our employees to, uh, at state expense.

[Pause in recording.]

GAINES: --received some from out of state to what--some of our programs. But there was a big boost in terms of morale as well as educational effort. And, uh, then when I left office, of course I, I finish--I left, also left my position as, uh, as the represen--Kentucky representative on the Mental Health Board, and my successor then became the Kentucky representative.

01:06:00

KLEBER: And you, uh, ceased being the commissioner of mental health at, at what time?

GAINES: Oh, gracious, I have forgotten the date.

KLEBER: Would it have been '56?

GAINES: I think it was in early--yes, '56.

KLEBER: Fifty-six. Who was your successor?

GAINES: Uh, um, Harold McPheeters, he had been my assistant commissioner during the later part of my, uh, time. And, I recommended to Governor Chandler that he be appointed when I re--uh, resigned, and he, he did.

KLEBER: Why did you resign?

GAINES: Oh, it's, it's difficult to talk about even yet--(both laugh)--but, I can tell you briefly. Um, Governor Chandler and I came to parting the ways primarily because he asked me to fire some people--some professional people which I refused to do. And uh, then it was a time for the parting of the ways, he wanted me to fire one of the hospital superintendents who was a bona fide psychiatrist and a good administrator; and also one of the business managers at 01:07:00that same hospital, because he was the son of one of his previous political opponents. This man in the hospital, never done anything wrong, Mr. Chandler, but memories--political memories go back a long way. And he demanded that this man be fired, and I told him he had not done anything wrong, and there was no reason for me to hir--fire him, so and I refused. And, now, he didn't say I had to go, but I figured that was time for me to leave, so I just, I resigned.

KLEBER: Thank you, Dr. Gaines. Perfect, good.

[End of interview.]