In 1966, inside a Massachusetts state institution called Bridgewater, a camera recorded a patient being force-fed through a rubber tube in his nostril. The man lay pinned to a table while a doctor poured liquid food into a funnel. Above them hung the doctor’s lit cigarette, ash trembling over the tube. Later in the same footage, the same man’s face appears again, now still, lying in the room where bodies are prepared for burial.
The film was real, shot with the state’s own permission. For 24 years, it was against the law to watch it. The documentary contained no staged violence, no state secrets, nothing a censor would call obscene. It remains the only American film ever banned from general distribution for a reason other than obscenity or national security.
The reason was simpler: the film showed what the place actually was. It showed a man arguing calmly and lucidly that the hospital was making him worse, and doctors responding by raising his medication. It showed men kept naked in bare stone cells while guards taunted them. And it showed a talent show that gave the film its deceptively cheerful name, Titicut Follies.
Massachusetts fought that film all the way to the United States Supreme Court—not to close the hospital, but to close the picture of it. A judge ordered every copy recalled and destroyed, as if the celluloid itself were the offense. While the film sat locked in a vault, the hospital stayed open. Men kept dying in it.
Four decades after the cameras were thrown out, another image would emerge: a surveillance tape of a 23-year-old man dying under the hands of his guards. Once again, the images would change nothing. Bridgewater did not begin as a hospital. It began in 1854 as an almshouse, a warehouse for the poorest people in Massachusetts, the ones no town would claim.
That founding purpose survived every name it was later given. In 1866, the state added a workhouse, where the poor were put to forced labor. In 1883, a fire destroyed the complex, and the state rebuilt it as a larger working penal farm. In 1895, one part was designated the state asylum for insane criminals.
Poor men, criminal men, and mad men were held on the same ground under the same administration, sorted mostly by paperwork. Whatever Massachusetts did not want to look at, it sent to Bridgewater. Two decisions defined the next century. In 1911, the legislature passed the defective delinquent law, allowing a man to be committed to Bridgewater indefinitely with no real due process, on the finding that he was mentally deficient and prone to delinquency.
The standard required no crime and no madness in a medical sense. It required only a prediction that this man would probably offend, and on the strength of that prediction, the state could hold him for life. A thief served his sentence and went home. A defective delinquent had nothing to serve.
The paperwork had no expiration date. It was a category with no exit. In 1919, control of the institution was handed to the state’s Bureau of Prisons, the agency that would become the Department of Correction. From then on, the place called Bridgewater State Hospital was run by the prison system.
Its wards were staffed by correction officers, not nurses. Its superintendents answered to prison commissioners, not doctors. Every other asylum of the era was a hospital that slowly came to behave like a prison. Bridgewater was the reverse: a prison ordered by its name to pretend it was a hospital.
In 1955, the state made it official, renaming the complex a correctional institution with a hospital somewhere inside it. In 1958, Governor Foster Furcolo tried to sound the alarm. He asked the legislature to take Bridgewater away from the Department of Correction and give it to the Department of Mental Health. The human suffering of the men at Bridgewater State Hospital, he wrote, was a challenge to the moral conscience of the Commonwealth.
The legislature did nothing. Five years later, in February 1963, the Boston Globe put a number on what the legislature had declined to look at. Reporters found 240 men inside Bridgewater whom the paper called the forgotten men—patients held there for an average of 30 years. Those were not the longest cases.
That was the average. Men committed as young laborers under the defective delinquent law were still there as old men, decades past any offense, because the law required no hearing, no review, and no proof that they were dangerous. A man committed at 22 the year the First World War ended was still on his ward when President Kennedy was inaugurated. Everyone from his old life had aged, moved, and in many cases died, each death quietly deleting one more person who remembered he existed.
By the mid-1960s, Bridgewater held roughly 900 men in that condition. There were civil commitments who had never been convicted of anything, prisoners sent from other institutions, men shipped in for 30-day psychiatric evaluations who sometimes stayed far longer, and the forgotten men of the defective delinquent category, all mixed together on wards run by guards. The doctors were few and stretched thin. For most men, treatment consisted of the ward itself: the routine, the line for medication, the yard, the cell.
In the spring of 1966, Frederick Wiseman walked through the gate, 36 years old, carrying a camera permit signed by the authorities. He was not by trade a filmmaker but a lawyer who taught at Boston University, and he had been taking students to Bridgewater for years. The superintendent believed, sincerely, that publicity might finally bring the money and attention the legislature had denied for a century. In the spring of 1966, the gate opened.
For 29 days, Wiseman and his cameraman filmed inside the walls, gathering 80,000 feet of film. Nobody performed for them. Everything the camera recorded was routine. It recorded the annual inmate talent show, which the institution itself called the Titicut Follies, after the old native name for the river that runs through the town.
Men in paper hats sang show tunes on a small stage, guards beside them. Wiseman opened his film with that stage and took the show’s name for his title. The rest of the footage showed men held naked in bare cells as the ordinary condition of the back wards, and old men standing in the cold in the yard, decades deep into commitments that had no end. It recorded a man named Vladimir, who stood before the staff and argued his own case coherently and precisely.
The hospital was making him worse, he said. The medication clouded him. The ward was doing him harm, and he asked to be sent back to prison, where at least his sentence would end. The doctors listened, then concluded that his complaint was itself a symptom, evidence of his paranoia, and they responded by recommending more aggressive treatment.
There was no villain in the scene and no raised voice, only a man reasoning with an institution that had already decided what he was, and losing by being right. Then there was the scene of Malinovsky, a patient who had been refusing food in his cell. The force-feeding was technically treatment, the institution keeping a starving man alive. But the film cut from the feeding to a later scene where the same man’s face, now still, was being prepared for burial.
The institution’s care had ended in that room. Wiseman put the beginning and the end side by side and let the viewer draw the line between them. 1967 was already a humiliating year for Bridgewater before the film ever screened. That January, the institution’s most famous inmate, Albert DeSalvo, the man who had confessed to being the Boston Strangler, escaped from the hospital with two patients.
The state recaptured him, but the fortress that could not treat its patients, it turned out, could not even hold its most notorious one. In the autumn of 1967, word reached the state government that the documentary was about to premiere at the New York Film Festival. In September, Lieutenant Governor Elliot Richardson, part of the same establishment that had approved the filming, prohibited the film’s distribution in Massachusetts. The state went to court in New York itself, trying to stop the festival screening in another jurisdiction.
It failed, and the film premiered on October 3, 1967. But inside its own borders, the Commonwealth dug in. The state’s argument was privacy. The men in the film were naked, degraded, and incompetent to consent to being shown.
To protect their dignity, the film must disappear. In January 1968, Superior Court Judge Harry Kalus agreed, denouncing the film as 80 minutes of brutal sordidness and human degradation, and ordered every copy recalled and destroyed. On appeal, the state’s highest court softened the destruction into a lock. The film could be shown only to doctors, lawyers, judges, and students of such fields.
The general public, the voters and taxpayers whose institution this was, were forbidden to see it. The United States Supreme Court declined to intervene. Massachusetts had recognized, for the first time in its history, a legal right to privacy, and its first application was to hide the state’s own hospital. The men of Bridgewater were held naked in bare cells, and their privacy was invoked to suppress the evidence of it.
No commission was appointed to fix what the film showed. The remedy was aimed entirely at the film. If the picture was gone, the problem, legally, was solved. Here is the cruelest irony.
The film the state buried had worked. In November 1967, weeks after the premiere, the state’s highest court ruled that a Bridgewater patient named Laura, committed indefinitely without due process, was entitled to his discharge. The next year, Elliot Richardson, now attorney general, the same man who had banned the film, launched the Bridgewater release project, a case-by-case review of the men the institution had swallowed. Of the first 300 patients examined, nearly half were found to be unlawfully confined.
Ninety-six men were moved to real mental hospitals, and others walked free entirely. But release projects end and buildings remain. In 1971, a citizens committee reported that conditions were unchanged since 1966. In 1972, the segregation unit was closed after investigators described it as a medieval chamber of horrors.
In 1974, the state spent $10 million on a new hospital building, but modern walls stood in for reform. In 1986, the state handed medical care at Bridgewater to a private contractor, the low bidder, and the staff began to drain away. Between November 1986 and the summer of 1987, six patients died. Among them were three suicides and one man who died in restraints.
In July 1987, a Boston attorney named Roderick MacLeish took the state to court on behalf of the patients, and that autumn a Boston television station took cameras back inside and broadcast a five-part series from the wards. In January 1988, Governor Michael Dukakis signed an emergency appropriation increasing the hospital’s clinical staff by 90 percent. Once more, it was the pictures that moved the money. In 1991, a superior court judge ruled that Titicut Follies could finally be shown to the public.
Part of the reasoning was constitutional, but part was simpler and colder: after 24 years, most of the men in the film were dead. Their privacy had expired with them. In September 1992, PBS broadcast the film to the nation, a quarter century late, as history instead of as warning. The state had run out the clock on its own evidence.
Every man whose dignity the ban had claimed to protect had died inside the system the ban had protected instead. Bridgewater State Hospital never closed. It stands today in modern buildings behind modern fences, still run by the Department of Correction. In the spring of 2009, its own surveillance cameras were rolling again.
Joshua Messier was 23 years old. He was not a convict. He was a young man with schizophrenia, sent to Bridgewater for evaluation, into the one facility in Massachusetts where the mentally ill are kept by the prison system. He had a mother who expected to get him back.
On May 4, 2009, in the grip of a psychotic episode, he struck a correction officer, and guards took him to a cell to place him in four-point restraints. The surveillance camera recorded what happened next. As they strapped him down, face down, officers pressed on his back, a maneuver known as suicasing, folding a man like luggage, a technique forbidden precisely because of what it does to a struggling man’s ability to breathe. Guards would later testify they had never received hands-on training in four-point restraints.
One officer told investigators he did not even know what a schizophrenic attack was. Joshua Messier stopped breathing on that bed. Nine months later, the state medical examiner ruled his death a homicide. For five years, almost nothing happened.
The Department of Correction’s own Internal Affairs Unit found misconduct and was overruled from above. Not one staff member was disciplined. The District Attorney declined to prosecute. In May 2010, patient Bradley Burns died at Bridgewater in restraints.
In August 2013, Paul Correia died of a blood clot after three days strapped to the bed. Three restraint-connected deaths in four years, none of them a public scandal, because nobody outside had seen them. In February 2014, Michael Rezendes of the Boston Globe, from the same Spotlight team that had exposed the church abuse scandal, published the story of Joshua Messier’s death. In the single month of December 2013, patients had spent more than 13,000 hours in seclusion or restraints.
Over all of 2013, roughly 300 patients logged some 148,000 hours, more time in seclusion and restraint than all 626 patients in the state’s actual mental hospitals combined. Under pressure, a special prosecutor was appointed, and in 2015 a grand jury indicted three former guards for involuntary manslaughter. In December 2017, the trial came. The court traveled to Bridgewater, and judge and lawyers stood inside the small cell where Joshua Messier died.
Eight years after his death, the verdict came in: the guards were found not guilty on all counts. The judge found their conduct left much to be desired, but not criminal. There was film of the death. There was a homicide ruling.
And there was, in the end, no one responsible. Joshua Messier’s death did force changes. In 2017, the state pushed through the largest reform in Bridgewater’s modern history. Clinical care was handed to a private medical company, and correction officers were moved out of the treatment units.
For the first time in a century, guards no longer run the wards. Seclusion and restraint hours fell steeply. But the guards moved to the perimeter, the company hired was a correctional health contractor, and the deeper structure survived. Bridgewater State Hospital remains today a facility of the Department of Correction, the only place in Massachusetts where a man who has been convicted of nothing can be held in the custody of the prison system because he is mentally ill.
Independent monitors documented hundreds of chemical restraint orders in a six-month span, dozens of unreported restraints and seclusions, mold in the buildings, and concluded that spending time inside is not safe for anyone. Every few years, another official report recommends what Governor Furcolo recommended in 1958: take the hospital away from the prison system and give it to doctors. That recommendation is now older than most of the men inside the walls. It has outlasted every governor who heard it, and it has never once been carried out.
Titicut Follies now sits in the National Film Registry, preserved by the Library of Congress as a culturally significant American work, an honored classic about an institution that is still in business. The film outlived its ban, outlived its judge, outlived nearly every man who appears in it. What it could not outlive was the idea it was banned for exposing: that there are people it is acceptable not to look at. The subject was never one hospital in Massachusetts.
It was the transaction at the heart of every institution of its kind—a society that pays with money and with silence to have its most disturbing people kept somewhere out of frame. Wiseman pointed a camera at the arrangement, and the state’s answer was to ban the camera. When the picture came back anyway, on a surveillance tape in 2009, the state’s answer was an acquittal. The reels are safe now in the archive, in the dark.
The men in them are gone. And on the old state farmland in Bridgewater, Massachusetts, behind the fences of the Department of Correction, the institution they tried to show us is open for business tonight.