Review: “Keeper Of The Keys” By Nadine Scolla

I was actually led to this book, which was published in 1976, by some research I was doing on Camarillo State Hospital in California. While the time period I’m researching is the middle of the twentieth century, and these events take place in the mid-seventies, I couldn’t pass it up.

Why? Well, first, I worked in healthcare (albeit in the information systems department) for 15 years, so healthcare is very much a part of me. Many loved ones are also involved in healthcare, I love watching shows like “E.R.”, “Grey’s Anatomy”, and heck, even “Scrubs”… Well, you get the idea.

Second, since junior high, mental health has always been fascinating to me. Many people who know me would say it’s because it’s like looking in a mirror, but what do they know. I really believe if I hadn’t gotten into computers and martial arts, I would have studied abnormal psychology. It’s all so fascinating.

Finally, I despise folks who take advantage of others, and that’s exactly what this book set out to expose, specifically at Camarillo State Hospital.

During the time frame I’m researching, mental healthcare was nothing like it is today, especially in the understanding of what is and isn’t a mental illness. Not to mention that many physically or developmentally disabled people were put in institutions, where today societal mainstreaming is much more common.

By the time this book was necessary, running mental institutions had become a business. Since the hospital was paid per patient, they would do anything they could to get and keep patients in their care. That, combined with overcrowding and employees with little or no training, led to a snowball effect of patient maltreatment. But who would do anything about it? The people doing the work often times weren’t qualified for the position, but they were paid well, so why rock the boat? Administrators certainly didn’t want to kill the golden goose. Unfortunately, those employees who did care, like Scolla and others she identifies in the book, could be blackballed with negative employee reviews in their records, so they were afraid to make waves for fear it could ruin their careers.

Enter Nadine Scolla, fresh from nursing school, where she was apparently taught very well the right way to treat patients and their families. During nursing school she kept a diary, and naturally she continued to keep it as she excitedly joined her profession of choice at Camarillo State Hospital.

She is shocked early on by what she sees as what passes for patient care: Ignoring patients experiencing seizures. Pulling gold fillings from a new patient’s teeth. Rape and physical abuse of patients. Adjusting or denying medication without doctors’ orders. And the list goes on.

Scolla finally cannot stand by anymore and, knowing that reporting problems to authorities won’t do any good since it will just be glossed over by those in power, takes other steps. She contacts a publisher about the issue, offering her diary as evidence. Therein lies the genesis of this book, the publication of which led to a grand jury investigation of CSH, a reformation of mental institution practices in California and, ultimately, the closing of CSH itself as its patient count declined over the next 15 years.

I really enjoyed this book, in many ways. It might appear that Scolla might have sanitized some of her entries, but I believe that was just her being a professional, a lady, and a woman of faith. But what she outlines in the book is detailed and to the point. It’s a fascinating look into not just this particular mental institution, but the standards of nursing at the time, when all nurses wore white, etc.

I definitely recommend this book for anyone interested in the mental healthcare during the seventies, nursing, or just a memoir by a young lady who risked her career by going against the grain.

Rating: 5 stars (out of 5)