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INTRODUCTION

This is a book about eugenics, which is to say it is a book about my neighborhood. When I started writing Pure America, I lived on one of the more elevated streets in Staunton, Virginia, a small city nestled in the Shenandoah Valley. For years, my daily routine played out in exactly the same way: I’d leave my apartment, coast down the hill a quarter of a mile toward Richmond Avenue, Staunton’s main thoroughfare, and catch a traffic light that put me nose to nose with the original campus of Western State Hospital, where, between 1927 and 1964, surgeons sterilized around 1,700 people without their consent.

When I describe the hospital like that, you might conjure up an image of my daily commute that seems ripped from the mind of Shirley Jackson: Western State, not sane, stood by itself against the hills, holding darkness within. But instead, what I came nose to nose with every day was a bustling construction project. The site—an assembly of buildings and land, including a cemetery that contains the remains of as many as 3,000 former patients—was being diligently transformed into a luxury hotel and an upscale property development marketed to retirees and second-home buyers.

In other words, Western State did not stand by itself at all. It was open for business, undergoing renovations that would soon turn it into the newly christened Blackburn Inn and the Villages at Staunton. Its new charm included the meticulous restoration of some of the site’s key architectural structures, but also a branding identity that claimed Western State was the home of an oddly cheerful history: patients who were well-cared-for by benevolent, moral physicians. When you heard the developers’ historical account of the hospital, which had originally been named the Western State Lunatic Asylum, the place felt so sumptuous that you wondered why people in the past didn’t feign insanity just for a chance to visit.

This was not the Western State Hospital that I knew.

A period of what is sometimes called “moral medicine” did indeed briefly exist there, from its opening in 1828 to just after the Civil War. In its earliest and more optimistic configuration, Western State provided respite for white patients who were experiencing acute distress that physicians thought could be relieved by rest, proper nutrition, and a routine of light work. This more humane treatment, the “moral” in moral medicine, was intended to help individuals “regain” their sanity in peaceful environments by setting aside methods such as restraint and corporal punishment that a new generation of physicians felt were unnecessary and brutal. In this period, individuals with more severe, incurable, or chronic conditions, both mental and physical, were cared for by their families ideally, sometimes with assistance from charities, or they were placed by communities or their kin in locally funded almshouses, orphanages, or jails.

But in the late nineteenth and early twentieth centuries, that approach was supplanted by a long era in the history of psychiatric medicine when therapeutic efforts primarily focused on containment and control, not care or cure. More and more, people perceived to have disabilities, along with those who couldn’t care for themselves due to poverty or age, were viewed by society as an expensive and disorderly class prone to criminal behaviors and indigence. Communities began to demand financial relief from the costs associated with helping them survive. By institutionalizing individuals in greater numbers, communities could pass their local financial costs to the state and rid themselves of people who were thought to lead unproductive lives. According to legal scholar Laura Appleman, by 1923 more than 263,000 people were institutionalized nationwide, which meant that “The first modern mass incarceration was not of criminal offenders, but of the disabled.”

Physicians and scientists abandoned their search for moral treatment and instead turned their efforts to prevention by quantifying and categorizing, with ever greater precision, the types and causes of what they considered to be mental incompetence. Their studies, helped by the invention of intelligence testing, produced new taxonomies of weakness, but they overwhelmingly agreed that these afflictions all had a similar root cause: bad breeding.

This was a problem involving both biology and economics. In addition to diagnosing their patients, physicians began enumerating the financial burden and social dangers associated with their survival. Proponents of a rapidly growing movement to study and control human breeding found the pressure point of a unifying message: allowing the “unfit” to reproduce was tantamount to creating a societal debt that could never be repaid. “Every 15 seconds 100 dollars of your money goes to the care of persons with bad heredity: the insane, feebleminded, criminals and other defectives,” read one series of advertisements circulated by the American Eugenics Society in the 1920s. Virginia made eugenic sterilization legal in 1924.

The Western State that I knew was largely a product of this longer historical era. The hospital’s superintendent from 1905 to 1943 was such a vocal leader of Virginia’s eugenics movement that people knew him as Joseph “Sterilization” DeJarnette. He was one of the state’s earliest proponents of population control, calling for marriage restrictions for the “unfit” in 1908. By 1911, he was recommending the sterilization of “all weaklings.” After Virginia passed its Sterilization Act in 1924, and it was affirmed by the Supreme Court in 1927, DeJarnette and the surgeons who worked under him at Western State performed the second-highest number of sterilization procedures in Virginia. Only the Lynchburg Colony, seventy-five miles to the south and designed specifically for feebleminded patients, outpaced it.

Western State remained a segregated hospital reserved for white patients until Virginia was forced to integrate facilities after 1965. Eastern State Hospital in Williamsburg, opened in 1773 as the first public hospital in the United States designed solely for the treatment of mental illness, functioned briefly as an integrated hospital between 1841 and 1870 (with a segregated basement wing for Black patients). After it reverted to a segregated facility for white patients, Eastern State performed 393 sterilizations between 1924 and 1964. In 1869, Virginia opened the Central Lunatic Asylum for Colored Insane in Petersburg, another first of its kind in the United States. It, along with its smaller Petersburg Colony, remained Virginia’s only facilities for Black patients until after integration. Central State performed 1,634 sterilizations, and the Petersburg Colony, which closed in 1955, performed 246. Virginia operated an additional facility for white patients near Marion as the Southwestern Lunatic Asylum, opened in 1887. Around 364 sterilizations were performed there between 1924 and 1964. The Lynchburg Colony, dating to 1910 and where the state confined many but not all white patients labeled feebleminded, performed at least 2,781 sterilization procedures.

Earlier in my life, I lived outside of Nashville among plantations, not hospitals. There my neighbor was enslavement, not eugenics. I am telling you this because when I first moved to Staunton, Western State froze me in a sense of déjà vu; I was again encountering local historical narratives that were dominated by people who were happy, yet forcibly detained, and fine architecture, instead of by trauma and corporeal violence. Enslavement is not eugenics, and yet the two felt familiar, as if all of those modern-day plantation weddings and antebellum architectural distractions had helped lead to a point where this deeply complicated site in Staunton had similarly turned into a valuable asset that was economically inseparable from the modern growth of the community around it.

Were the cheerful stories the developers were telling about Western State intended to achieve some kind of historical balance? Were they meant to help the site and the community move beyond the stigma of eugenics? Or was this more anodyne history just designed to please wealthy property owners and visitors who wanted to stay there? The transformed Western State Hospital boasted new numbers city residents could celebrate: a $21 million investment from developers, $1.2 million in tax credits from the state and federal government, and $595,000 properties for sale. But there were other numbers from its past that now felt unseemly to say out loud: 1,700 lives altered, thousands of graves.

“But the site has good bones,” I heard people in town say, praising Western State’s architectural pedigree and thinking charitably about the transformations and profits still to come. Poet Maggie Smith tells us:

Any decent realtor,

walking you through a real shithole, chirps on

about good bones: This place could be beautiful,

right? You could make this place beautiful.

Well, this is a book about being uncharitable.

Pure America is a history of Virginia’s eugenics movement, including the role Western State Hospital played in it. But it is also about the way I see that history in the built world and natural environment I experience every day. My regular encounters with Western State helped me realize in a visceral way that eugenics didn’t just alter the lives of people, it also altered land and geography. It changed how institutions grew, and it gave Virginians confidence that they could claim the physical world just as readily as they claimed the bodies of its citizens. These alterations also produced assets and provided convenient ways to mark geographies as pure or unpure. All of these changes had economic implications, and they’re intimately tied into very real profits and losses in the present.

But the world described in this book is simply the world of my daily commute. On many days, I make my way east from Staunton for a forty-mile trek to Charlottesville. That journey takes me past Western State, through the mountains, past the southern entrance to Shenandoah National Park, and into a city that is inseparable from the University of Virginia. These are my landscapes, each of them different in terms of their physical environment and the layers of this story they can reveal.

Charlottesville, for example, was home to Carrie Buck, who was the central figure in Buck v. Bell, the 1927 Supreme Court case that legalized eugenic sterilization nationwide. Raped by her foster mother’s nephew, Carrie was institutionalized so her foster family could avoid the scandal of her pregnancy. She eventually became the first person legally sterilized in Virginia. I often drive past the cemetery where she is buried and through the neighborhood where she lived before her commitment to what was then called the Virginia State Colony for Epileptics and Feebleminded in Lynchburg. I take this route because it’s the most convenient way to get to Charlottesville’s downtown mall, where my partner Josh works.

That mall is still marked by the efforts white citizens made to claim territory for themselves during the eugenics era. In 1921 and 1924, city residents placed two large Confederate statues here. Almost a hundred years later, those same statues served as the focal points of violence during 2017’s Unite the Right rally. The University of Virginia, about a mile to the west, participated heavily in the pageantry that accompanied the statues’ original placements. In the early twentieth century, the university also functioned as an academic larder well-stocked with eugenicists, an institution described by current UVA history professor Elizabeth Varon as “an incubator for Lost Cause ideology.” Ambitious white faculty, eager to enhance their reputations, claimed as scientific law the truth of their own genetic perfection and taught students who would go on to populate Virginia’s highest political offices, the medical field, and the law.

The area’s surrounding mountains, both the ones I see during my commute and the ones that greet me as more distant landscapes when I arrive back home, were prized by Virginia’s earliest psychiatrists, who believed natural beauty could soothe troubled minds. But twentieth-century eugenicists also saw them as sinister geographies crawling with people they thought of as “mongrels.” My commute runs right past a turnoff for Shenandoah National Park. Since 1935, the park has been one of the most robust drivers of regional tourism, but that success was achieved through the removal of 500 mountain families through a new form of eviction—eminent domain—that Virginia used to ease the process. The sweeping laws the state passed in 1928 to help the park’s development set in motion a chain reaction that brought more and more people to the mountains to determine what should happen to families too poor to leave the park on their own. For some, what would happen were institutions like Western State and the Lynchburg Colony.

I’ve tried to understand how all these locations that punctuate my commute—places of violence, racial supremacy, and displacement—connect to the layers of history in Western State’s past. In Staunton and at the renovated hospital, questions of profit and loss are always in the foreground. The city’s local economy is not only reliant on tourism connected to the surrounding mountains, but also on its ability to project a wholesome, historic image. Boosters argue we’ve earned the ability to move beyond the city’s darker chapters. But what does it mean when the local economy is still extracting profit from them?

Looking at eugenics through the variation of landscapes and their economies has helped me understand how acolytes of eugenics moved through a similar constellation of ideas even while their primary motivations and targets were different. For some, eugenics was part of an unrelenting campaign of white supremacy. For others, it was a partial solution to control “troublesome” women. For many, it was a more ambiguous and opportunistic tool that helped elite Virginians extract profits or take assets from poor people by arguing for the biological truth of their unworthiness.

Like geographies, these motivations aren’t seamless. They aren’t always easy to locate either. They are everywhere, but because eugenics is best understood through the history of ideas and not places, they are also nowhere at all. How could it be that I live at the epicenter of Virginia’s eugenics movement and see almost nothing around me today that tells that story? From that paradox, Pure America was born.

I don’t want to give the impression, however, that Pure America is a secret history of anything. “Virginia Ran a Secret Eugenics Program that Didn’t End Until 1979,” an article on Medium tells me. Nature calls it “America’s Hidden History.” The New Yorker encourages us to remember “The Forgotten Lessons of the Eugenics Movement.” In Virginia, just like the rest of the world, these facts of history haven’t been forgotten. It’s just that powerful people have oriented the past around stories they feel are more important to tell.

This may sound like a subtle difference, but I assure you it is not. Forgetting is passive, organic, even gentle at times. Intentionally crowding a collective history with elements that are specifically designed to ease discomfort or conceal controversy is active, intentional, coercive.

My ability to discover evidence of Virginia’s eugenic past in the landscape of my daily life was buttressed by my background as a historian, someone supposedly trained to look at the past accurately and call it for what it really was. But in spite of that training, in Staunton I felt a familiar pull. Wouldn’t it feel better just to give in and only think about the hospital through stories about happy patients and beautiful architecture? After all, the old version of the site didn’t tell stories at all. It was just a derelict collection of buildings. Would it really be so terrible to put them to new use? Wouldn’t it be better to have something there instead of nothing?

Arguments like these were familiar to me, and these questions are far from settled, even among people who have spent their entire careers thinking about them. But what I can tell you is that the current reconfiguration of Western State started to make me feel what historian Kate Brown describes when she writes, “at some point even the wreckage progress leaves in its wake becomes profitable.” When we recover some stories about the past and set aside others, we are often placing real, material value on those stories. Even if some questions remain unsettled, an acknowledgement of this truth is required. Now, because of my inability to let go of Western State’s past, the site makes me feel like I have failed to be a good member of my community who is invested in its economic future. That is often what I hate most about it.

Calling Virginia’s eugenic past a secret history also runs contrary to the work of important scholars who have already written extensively about the eugenics movement and its connected goals. One of those scholars was my dissertation adviser, Pippa Holloway, whose book Sexuality, Politics, and Social Control in Virginia, 1920–1945 follows the state’s attempts to regulate the sexual behavior of its “undesirable” citizens. Katrina Powell and Sue Currell have researched and written about the displacement of families at the Shenandoah National Park. Two of the country’s leading experts on American eugenics, Paul Lombardo and Gregory Michael Dorr, began their careers by making Virginia’s past their primary subject. Dorr’s account, Segregation’s Science, was the first book I reread when I moved to Staunton and felt my mind starting to slip. I began asking people, “That’s the Western State, right?” as if there might be another former asylum in town that hadn’t become $500,000 condominiums.

These scholars, and many others, have examined eugenics from the perspective of law, policy, and science. They’ve written about it as a set of ideas and an extension of state bureaucracies. In two cases, their work has even helped create compensation programs for victims of eugenic sterilization. North Carolina created the first program in 2013, due in part to historian Johanna Schoen’s work on the state’s Eugenics Board, and Virginia enacted a similar program in 2015. Victim advocacy by disability and reproductive rights activists also helped create these and other measures, like the repeal of state laws that permitted eugenic sterilization well into the twenty-first century. But despite all of this work, as a nation we are still coming to terms with the legacy of eugenics, even though its origins and early applications are well-documented. Its legacy still exists in our current immigration laws and our for-profit health care system. It underlies our fascination with mail-in DNA tests and ancestry. It informs the rhetoric politicians use to talk about public assistance. Just as it was in the past, eugenics is everywhere and nowhere at the same time. It just depends on how much we’re willing to interrogate how power works in the world we live in today.

If the history of eugenics does have an element of secrecy, though, it’s this: sterilization statistics can be finicky, and it is not uncommon to read minor variations in reported numbers depending on the source, its purpose, or when it was produced. I tend to rely on Gregory Dorr’s work for statistics during the eugenics movement in terms of operations performed and breakdowns according to gender and race. But it is important to note that individual patient records, even those of patients who are long dead, are still protected by medical privacy laws. It’s likely that Virginia buried patients anonymously at Western State, for example, using only numbered markers, precisely for this reason.

But the majority of my archival sources are housed at the Library of Virginia in Richmond and the University of Virginia Special Collections in Charlottesville, places that aren’t secret at all. For the most part, the only credential I needed to access this information was an ordinary Virginia library card. When you hear the phrase “secret eugenics program,” it conjures up images of someone furtively fingering through file boxes in a basement while someone else watches the door. But the process really just involved me sitting in a comfortable room while the on-duty archivist retrieved files that had been meticulously arranged by thousands of hours of labor.

So please, I am not here to reveal secrets. What I want to do instead is give Virginia’s eugenic past a sense of place and bring it home, to find it like the faint pencil mark in a childhood closet that recorded how small you once were.

Here is something about this book that might get me into trouble: I think most eugenicists were bad people. There will be no “man of his time” hedging here. In Staunton, for example, DeJarnette, to the extent that his legacy is acknowledged at all, is often contextualized today as a person with flawed but “deeply humanitarian motives.” That’s how the local newspaper remembered him in 2014, the same year Virginia lawmakers sought to compel the state to authorize reparations for survivors of eugenic sterilization. “Letters to DeJarnette filed in the state archives show writers from many social ranks relating to him with high personal and professional regard.” This was a man who wrote poems musing whether or not Black people (although he didn’t call them that) should be allowed into heaven.

When people today try to contextualize figures like DeJarnette this way, I know what they’re trying to do. They mean that these beliefs about good breeding and racial supremacy were endorsed by a critical mass of white leaders and intelligentsia. They were ingrained to such an extent that we might call them “typical” when we’re trying to determine how powerful people during this era thought the world should work.

But what would the people who were targeted by eugenics say? Are we implying that the record number of immigrants ensnared by these beliefs would be comforted by the fact that history would eventually prove that they weren’t of a different species? No. Did elderly women and men cope with their forced childlessness by understanding that doctors had tried their best but simply got it wrong? Again, no. What those people would say, and what they have said, is that nothing about what was done to them made any sense. If some of us are able to make sense of it now, because it did not happen to us, then that is a gift. But it does not grant us permission to build a legacy on a series of excuses.

I will not be scolded for imagining men like Joseph DeJarnette, Walter Plecker, Aubrey Strode, or George Pollock in the way I understand them, as individuals who derived status and pleasure from the power they wielded over vulnerable people. I do not care if someone accuses me of the ultimate historical sin of judging people in the past by the yardstick of the present. I do not subscribe to the view that time is the real villain of this story, that it tormented important people with difficult questions—like what the cheapest way was to castrate a prisoner—that only an accident of fate forced them to answer.

Eugenics made a mask from the newness of things; from the power to transform old evils into modern interventions. To use a more locally inspired turn of phrase, eugenics painted fresh white columns on an old building filled with shit and sold it. After all, it had good bones.

Lurking beneath the sound and fury of the eugenics movement and its language of defectives, mongrels, and misfits is a set of brutal yet recognizable beliefs about the kind of lives people on the margins deserve. Thinking of eugenics more broadly as a world-building enterprise has helped me understand how a quest for economic purity was just as important to eugenicists as racial and genetic purity were. Early twentieth-century eugenicists argued for the elimination of the unfit based on what they saw as the group’s potential to siphon resources away from the more deserving and to transmit debts onto future generations. If the eugenicists were successful, they figured the rate of return on their actions would be enormous. It would relieve the burden on prisons, institutions, and welfare offices and end the need to help engineer the survival of people who had no right to be alive and yet were.

Often, when we talk about eugenics now, even when we are attentive to the lives of the people it ensnared, we emphasize that this was the world that eugenicists were trying to create. Eugenics itself provides the framework for this perspective; it was always building toward a future goal. Sometimes for our own comfort, we also emphasize the failure of eugenicists. We understand their beliefs endured in some way—in debates about welfare mothers, immigrants from shithole countries, or work requirements for public aid recipients, for example. But as Audrey Farley writes in her essay about the cultural legacy of the eugenics movement, a tendency remains to “situate eugenics in the remote past.” That emphasis on remoteness, on the ways eugenicists tried but failed, sometimes obscures a way of seeing the world they actually made and how it lives on in the present.

For many people, the endurance of those beliefs is what matters. I hope this book shows how real and physical that endurance can be. In showing you the map of my world, I also want to show you how you might make your own. As Muriel Rukeyser puts it in The Book of the Dead, “These roads will take you into your own country.”

This book is about what was taken and how it helped build the world around me, in Staunton and beyond. It is also about the wealth and power that still circulate through that world-building endeavor. It is a book about imagining eugenics as it still exists in sites like Western State Hospital, thrumming in place like Rilke’s torso of Apollo: “still suffused with brilliance from inside, / like a lamp, in which his gaze, now turned to low, / gleams in all its power.”

“This is a story within a story,” I tell myself. And this is how it starts.