Mary Ellen Mark's poignant scrapbook
June 1978
Ronald H. Bailey
Art Director: William Hopkins

"She was feeling lost, bewildered-just as any teenager sometimes does," says Mary Ellen Mark of the young patient above.

In the unblinking compassion of her camera, their faces reflect the kaleidoscope of human emotion -bewilderment, love, pain, joy, anger, even a light-hearted mimicry of the contorted mask we call madness. These might be the faces, Mary Ellen Mark is telling us, of ourselves and our friends. In fact, they are the faces of women whose moods often go haywire, whose human impulses catapult to such extremes that they exceed the arbitrary limits society has set on sanity. One woman communes with the buzzard she is convinced resides under her bed. Another woman, believing herself pregnant, bares her stomach to the television set so that the unborn child can watch "Sesame Street" with her. A third woman, in a moment of self-loathing, seizes a shard of glass and carves the word "hate" from the flesh of her arm.

These women are patients in Ward 81, the maximum security section of the Oregon State Hospital. For 36 days, Mary Ellen Mark lived with them, sharing and recording their moods. Though Mark is best known as a photojournalist, her aim was not to document the problems of mental illness nor even to tell a story in the usual sense. "Instead of the 1-2-3-4 of a picture story, I was interested in doing pictures that would stand alone," she recalls. "Looking back now, I feel that the pictures are almost like a scrapbook, a memory of a certain time in my life and in theirs. I wanted to help these women make contact with the outside world by letting them reach out and present themselves. I didn't want to use them. I wanted them to use me."

The patient at right "is putting me on-she's saying 'this is what you think it's supposed to be like to be crazy."
"These are different aspects of the personality of one woman, "says Mark.

Posing beside a childhood portrait of herself and her sister, who is also a patient in the hospital, that her father had brought that day.

Above: She is laughing in her bed, her limber arms wrapped about her.

At other times she can be capricious and childlike, as when taking a bath and hiding from the photographer.

"The women had very, very strong personalities," says Mark. "Some of them were funny, some romantic, some social. You could label them just the way you might label your friends -this is the comedian, this is the romantic, this is the social one, and so on. The difference was that the feelings were so much more exaggerated. There's no bullshit; the emotions are pure."

I wanted to capture the different aspects and ranges of these personalities. I didn't want to get into their case histories, didn't want to be forced to put people into pigeonholes, saying ‘Aha! This one is schizophrenic, this one is paranoid.' It was a project of my own and I just wanted to do photographs that I believed in without having any rhyme or reason or theory, or having to spell out a sort of storytelling. I wanted their personalities-that was the thing that drew me to them.

"Some of the women were like actresses, incredibly sensitive to the camera. But others-like the patient shown here, who became my favorite-couldn't control the way they acted. They acted in the only way they could."

300B-001-022 The bewildered teenager shown earlier submerges herself in the solitude of the bath.


"This woman was very romantic-in the way she dressed, in her relationships, in her fantasies. She was always wearing everyone else's clothes and putting on costumes. She had a sense of passion and feeling about other people."

"Once (above) she became angry about something and beat her one hand against the table. All the women had strong relationships with one another. Some were positive and some negative. They felt a real sense of community. Deep friendships were very important in helping the women get better."

One of the punishments for misbehavior in Ward 81 is 24 hours in the isolation room -four walls with an escape-proof window and a thin vinyl pad bra bed.

Mary Ellen Mark discovered Ward 81 while photographing on the set of One Flew Over the Cuckoo's Nest, which was filmed at the Oregon State Hospital. After spending several hours talking to the women and photographing them, she resolved to return and do an entire book. It took nearly a year of letters and telephone calls before Mark won permission from the patients, their families, and the hospital. Even then she had to agree not to identify the patients by name or divulge their case histories.

The concessions didn't bother her because she intended to depart from the traditional photojournalistic approach. What worried her, she recalls now, was "the fear that the patients might reject me." Getting close to people is the hallmark of her work, distinguishing such documentary essays as heroin addiction in London (for Look), and WAC boot camp and the civil war in Northern Ireland (both for Ms.). "For me, the essence is familiarity," she states emphatically. You have to get close -close enough that people know you, accept you, and then forget the camera."

The prospect of getting close to 20 women deemed the most disturbed in the state of Oregon might have deterred a photographer lacking Mark's spunk and the intensity which lies beneath her fragile appearance. A few of the patients had been lobotomised. Many were receiving regular electroshock treatments. All were considered harmful to themselves or others, and at night the ward echoed with their cries.

Mark moved into an unused room next to the ward, taking with her a writer, Karen Jacobs, whom she had known when they were growing up together in suburban Philadelphia. For 36 days they didn't leave, except to go out twice for hamburgers to enhance the hospital cuisine. To help break the ice with the patients, Jacobs used a tape recorder, which allowed them to speak their minds freely, and Mark set up a Polaroid camera to make occasional portraits against the backdrop of a hospital sheet. The patients carefully groomed themselves for the portrait session; one woman even put sequins on her eyelids. Another explained, "I need a picture to send to my mother so she'll come visit me."

Working solely with 35mm cameras, wide-angle and normal lenses -28, 35, 50, and 55mm- and a sharply focused sensitivity, Mark soon learned to anticipate the quickly fluctuating moods of her subjects. "You had to be very sensitive to what state someone was in because you could really overstep your bounds," she says. "Some patients might suddenly get angry and hit you. The drugs make them that way. They're supersensitive to changes."

Mark spent much of her time talking with patients and tending to little needs. She polished the nails of one, for example, and took another swimming for the first time. The latter patient, Mark recalls, "was curled in a little ball when we got there. She wouldn't say anything. She became my favorite patient. She would get all scrunched up in a corner and I'd go over and straighten her up and say, 'C'mon.' You could make her function.”

"As a joke," says Mary Ellen Mark (above), "this patient came up and bit my nose."

Mark came away from Ward 81 with 200 rolls of film, which she had painstakingly edited into a powerful show, exhibited at Manhattan's Castelli Uptown Gallery, and a book to be published this year by Simon & Schuster. She also came away with the conviction that "drastic changes" are needed in Ward 81. "It's not a snakepit," she says. "It's probably one of the better state hospitals. But I feel that if it had more money, more staff, these women could make great steps."

Mark remembers most fondly the lively humor that kept popping up unexpectedly, much as it did in the movie Cuckoo's Nest that launched her on the project. The fact that Mark was sometimes the butt of the jokes suggests that her subjects, far from rejecting her, had accepted her as one of their own.

-Ronald H. Bailey