Inside The Madhouse

Think of a time in your life when you were struggling.

Maybe you were depressed or physically sick.

Maybe you were broke and couldn't find a job.

Or maybe you were just angry about how unfair the world can be sometimes.

Imagine for a minute if someone had come to you when you were at your lowest and said, I'll help you, just come with me.

Now, imagine they took you to a doctor or a judge, declared you insane, put you in a locked room, and never let you out again.

That sounds like a nightmare, but it's not.

It's how America and a lot of other places used to deal with people believed to be mentally ill or just poor and sick, especially women.

Not that long ago, words like hysterical, insane, and lunatic weren't just terms used to describe women.

They were clinical diagnoses used by actual doctors.

And far too often, For those unfortunate women given those labels, the simple act of arguing that they were sane was all the evidence needed to prove they weren't.

That is, until one person came along who exposed everything.

On today's episode, Inside the Madhouse, this is a twist of history.

It's early morning on September 24th, 1887, at the Temporary Home for Females, No.

84, a cheap boarding house on 2nd Avenue in New York City.

23-year-old Nellie Brown sits perched on the side of a bed, watching cockroaches skitter across the floor.

Nellie's fingers twitch and her hollow eyes dart back and forth as she fixates on the insects.

Their hard exoskeletons and spindly legs make them look like monsters in the candlelight.

Nellie has just spent her first night at the boarding house, a place with very strict rules for its poor young female occupants.

In the late 19th century, houses like this have started to spring up in big cities because rapid industrialization has led to a greater demand for women workers.

For the first time, unmarried American women are moving to cities in large numbers to get jobs as seamstresses or in factories.

But they're paid less than men and have few or no property rights.

So they struggle to find their own places to live.

They often end up in homes for women that cost about 30 cents a night, a little over $10 today.

But these homes have a second purpose beyond just providing housing.

They also help enforce society's rules for female behavior.

Every home has a matron who is in charge of monitoring the young women's morality and chastity.

And women who don't conform get kicked out or worse.

And Nellie Brown is not conforming.

Nellie's first night in this boarding house has been rough.

She has already insulted the other women and argued about where to sleep.

She's already been awake for two days straight and she has no intention of laying down and shutting her eyes now.

Instead, she starts to laugh.

Nellie hears a creaking sound from across the room.

She looks over and sees the young woman she's sharing the room with sitting up in bed, staring at her.

The woman asks if Nellie is okay.

but Nellie doesn't answer.

She just keeps laughing.

The young woman looks worried.

She climbs out of bed and wraps a blanket around Nellie and tries to calm her down.

Nellie knows she's making a lot of noise, but she won't stop.

Soon, Nellie hears footsteps coming down the hallway.

She looks up and sees the assistant matron of the boarding house, Mrs.

Stannard, coming into the room, followed by several young women.

Mrs.

Stannard demands to know what's going on.

Nellie's eyes narrow.

She doesn't answer Mrs.

Stannard's question.

Instead, she asks a question of her own, in a voice that's loud and frantic and accusatory.

Where are my trunks?

Nellie yells.

My trunks with all my clothes.

Mrs.

Stannard stares at her like she's crazy.

Nellie never had any trunks.

She had no luggage at all when she checked into the boarding house.

Mrs.

Stannard tries to tell her this, but Nellie won't listen.

She keeps shouting about her trunks and says, in her Midwestern accent, that she's from Cuba.

Some of the young women start to laugh while others look frightened.

But Mrs.

Stannard smiles.

She says that she'll help Nellie find the missing trunks.

Nellie watches Mrs.

Stannard whisper to one of the other women, who disappears down the hall.

Not long afterwards, two police officers appear in the doorway.

At first, Nellie pretends not to see them, but then one of them promises to take her to find her missing trunks.

Finally, Nellie cooperates.

She gets up, puts on her shoes, and follows the officers down the stairs and outside, into the early morning sunlight.

As they walk down Second Avenue, Nellie hears the sound of rattling steel tracks as the new elevated train rumbles through the neighborhood.

Her gaze jumps back and forth from the train to the street, as jittery as when she was watching the cockroaches.

She studies the mix of working-class men and women hurrying to their jobs, and the wealthy people in fine clothes riding past in small horse-drawn carriages.

America is smack in the middle of the Gilded Age, a period of massive economic growth that is changing the country's economy from agrarian to industrial.

The rich are getting richer, but they're doing it by exploiting the poor.

There's enormous corruption and greed, and the gap between the haves and the have-nots has never been wider.

Nellie tells the officers that the streets are dirty and that there are too many working people.

Who are they?

Nellie asks the officers, and she watches their faces fill with expressions of pity.

She goes back to mumbling about her trunks.

After walking a few blocks, they stop in front of a large stone building.

Serious-looking men in suits are filing in and out, and this gives Nellie an idea.

She looks up at one of the officers and asks if all these people have lost their trunks, too.

The officer tells her, yes, and now, he says, they'll be able to find hers.

The officers lead Nellie inside the stone building down the busy hallway and into a small room.

Nellie sees a man in a black robe sitting at the front.

The officers go talk to the man, then the man smiles at Nellie and starts talking to her like she's a child.

He asks her name and her age and where she's from.

Nellie tells him what she told Mrs.

Stannard.

She's Nellie Brown.

She's 23.

She's from Cuba and she's here to get her trunks.

She says it over and over again.

The man in the black robe spends a long time talking to the police officers and Nellie feels her heart start racing and her body start trembling.

She's starting to fear that she's not going to get what she wants.

But then the man in the black robe walks out and returns a few minutes later with another man, this one wearing a white coat.

Nellie knows immediately, this man is a doctor.

He looks in her mouth, he holds up a light in front of her eyes, and he listens to her heart.

Nellie holds her breath.

Finally, The doctor makes his diagnosis.

He announces that Nelly is insane.

Nellie barely has time to process her surprise before the two police officers once again grab her by the arms.

They lead her out of the room and through a door in the back of the building, where an ambulance wagon is already waiting.

The police put Nellie on the wagon and step away to go speak to the driver.

And this is the first time Nellie has been alone since she left the boarding home.

So when the police officers turn their backs, she relaxes.

Her face shifts from a mask of agitation to an excited smile, and she has to slap a hand over her mouth to keep from laughing.

But this isn't the maniacal laugh she'd let out in the boarding house.

This is a laugh of pure joy.

She can't let anyone know how happy she is, because Nellie Brown is not really Nellie Brown at all.

Her name, at least her pen name, is Nellie Bly.

She's a journalist, and she's undercover.

Her mission is to expose the terrible mistreatment of people with mental illnesses inside New York City's psychiatric hospitals.

Everything she's done this morning has been designed to lead her here, sitting in an ambulance outside a courtroom.

Nellie has convinced a boarding house full of women, the police, a judge, and a doctor that she's insane.

Now she just has one more stop at a public hospital called Bellevue before she makes it to her final destination, one of the most notorious mental hospitals in America.

A terrifying place where patients are rumored to be abused and even left to die.

It's a fortress-like stone building on an island in the East River.

Its official name is the New York City Lunatic Asylum.

But most people just call it the Madhouse.

The next day, it's late afternoon on September 25th, 1887, at Bellevue Hospital on First Avenue in New York.

Journalist Nellie Bly has been examined repeatedly by the doctors here.

and despite the fact that she is only pretending to be mentally ill, they have declared her to be positively demented and a hopeless case.

They say there is now only one place for her, the New York City Lunatic Asylum, which houses 1,600 women.

Nellie is shocked by how easy it was.

Both Nellie and her editor at The World, which is the newspaper she works for, thought that she would have a much harder time getting committed to the asylum.

In fact, the paper's owner, Joseph Pulitzer, who is one of the most powerful newspaper magnates in America, told Nellie that anyone who smiles as warmly as she does and who is as kind as she is would never convince people she was insane.

That's why before Nellie checked herself into the boarding house, she had stayed awake for 48 hours and practiced being the insane woman, Nellie Brown, like an actor preparing for a role.

She had perfected her darting gaze and unblinking stare, and she came up with Nellie Brown's backstory.

She's a woman woman looking for lost trunks that clearly don't exist, and who is convinced she's from Cuba when she clearly isn't.

In reality, Nellie Bly was born outside Pittsburgh, Pennsylvania, the 13th of 15 siblings and half-siblings.

Her given name was Elizabeth Cochran, though female journalists typically wrote under pen names and Nellie took hers from a popular song at the time.

Nellie's early childhood had been happy and comfortable, but when she was just six years old, her father died suddenly and her mother remarried a man who was an abusive alcoholic.

Nellie's stepfather beat her mother until her mother feared for her life and divorced him, which was social suicide for a woman at the time.

Because of this, Nellie learned early on how easily a man could destroy a woman and how little power a woman had to stop him.

This lesson has shaped her life.

It's why she got into journalism in the first place.

to fight for women's rights.

She got in her first reporting job as a teenager after writing a letter to a Pittsburgh newspaper saying how disgusted she was with an article they'd run titled, What Girls Are Good For.

The author of that article had concluded that the answer was doing housework and having babies.

But despite the fiery letter that initially got Nellie hired, she spent most of her career, up until she started working for Joseph Pulitzer at The World, having to cover women's topics like fashion and entertainment.

Only 2% of journalists were women, and most men just didn't take women like Nellie seriously.

Today, inside Bellevue Hospital, Nellie is using the fact that she is so easily dismissed to her advantage.

She's sitting quietly on a hard bench outside the office of the doctor who is examining all the women in the psychiatric ward.

No one is paying any attention to Nellie, but Nellie is paying very close attention to everything around her.

She's listening hard through the door.

because she's starting to realize that the doctor is simply declaring everyone insane, whether it's true or not.

Bellevue Hospital is the oldest public hospital in the United States, founded in 1736, 40 years before the American Revolution.

It was originally part of the city's almshouse, which is a charity for the poor, and even after the almshouse was gone, Bellevue kept its commitment to treating the poor.

But there are so many poor people now that the hospital has become a kind of dumping ground for those with nowhere else to go.

That's especially true of the psychiatric ward of the hospital, where Nellie is now.

Nellie has been talking to the other patients, and almost all of them are poor women who got physically, not mentally sick, but whose families couldn't pay for treatment, so they were taken to Bellevue and committed.

Through the door, Nellie hears the doctor asking each woman if she sees faces that aren't there or hears voices.

Each woman denies it, but one by one, The doctor declares them mentally ill anyways and says they must be taken to the asylum.

The doctor steps out of his office.

He is getting ready to go home.

But before he can leave, a young woman about Nellie's age hurries over.

Nelly can see that this woman is physically ill.

She's pale and thin and trembling.

Nellie listens as the young woman tells the doctor that her name is Tilly Mayard and she's not supposed to be receiving psychiatric care.

She says her friends brought her to Bellevue for medical treatment.

She's sick and she's been diagnosed with something called nervous debility.

Tilly tells the doctor that she must be let out immediately.

But as Nellie listens, the doctor just laughs in response.

He says that Tilly isn't getting out anytime soon, and then he walks away.

From her spot a few feet away on the bench, Nellie understands exactly what is happening.

At this time in America, women suffering from a range of physical conditions like fatigue, migraine headaches, or even muscle pain are often diagnosed with nervous debility or nervous exhaustion and sent to mental hospitals to recover.

This is just the latest version of a practice that has existed for centuries.

Men pushing the idea that women are mentally fragile and prone to hysteria.

This type of diagnosis can be traced back at least to the ancient Greeks who developed the wandering womb theory, in which they argued that the uterus, or what they called the hysteria, could move around a woman's body and make her hysterical.

This, and medical theories that developed in its wake, eventually led to full-scale attacks on women who were deemed hysterical, like the European witch hunts in the 14th and 15th centuries and the Salem witch trials in 17th century America.

Nellie can see as plain as day that Tilly Mayard is just as sane as she is, but she knows it doesn't matter.

Once a woman is diagnosed with nervous stability or nervous exhaustion, it becomes possible to discount everything she says as hysterical ranting and shut her up.

or send her away.

A nurse eventually comes and takes Nellie back to her locked room.

Nellie and Tilly and the other women on the psychiatric ward at Bellevue spend another long night on their hard, thin mattresses.

The boat to take them to the madhouse will arrive tomorrow at 1.30 p.m.

Everyone, including Nellie, is terrified.

It's just after 1.30 p.m.

on September 26, 1887.

Journalist Nellie Bly steps off of a boat and onto a wharf on the East River alongside the other women from Bellevue Hospital's psychiatric ward.

Nellie has feigned insanity in order to go undercover and investigate one of New York's most notorious mental institutions, a place everyone calls the Madhouse.

Now, her plan is coming to fruition.

She has arrived.

The Madhouse sits on Blackwell's Island, which is known as Roosevelt Island today, located in the East River between the boroughs of Manhattan and Queens.

On the the wharf, a male orderly snatches Nellie by the arm and loads her onto an ambulance wagon nearby with the other women, including Tilly Mayard, who looks very sad.

The orderly climbs up next to Nellie, shouts to the driver, and the wagon heads across the island.

Nelly knows that since she's here, everyone will simply accept that she's insane, so she no longer worries about keeping up her act.

She also knows that in 10 days, Mr.

Pulitzer, her paper's owner, will send someone to come and take her home.

In the meantime, she just has to be observant and mentally catalog everything she sees.

The asylum on Blackwell's Island is a source of horror stories, about women disappearing never to be seen or heard from again, and of unspeakable abuse and torture.

But the fact that the asylum is hidden away from the city has left it wrapped in mystery.

Nellie doesn't know what's fact and what's myth at this point.

At first, when she looks out over the island, she's taken aback by how green everything is.

Trees, plants, and flowers grow all around, and it looks like a beautiful public park.

For a moment, Nellie wonders if she had it wrong.

Maybe Bellevue Hospital was the worst of it.

Maybe here, in the asylum, these women will be cared for.

But that thought vanishes when the wagon approaches a massive rectangular stone building that rises up above the trees.

It looks like a penitentiary.

Even though she knows the answer, Nellie asks the orderly what this place is.

He looks down at her and says, an insane place, where you'll never get out of.

The New York City Lunatic Asylum had opened up almost 50 years earlier in 1839, and it was supposed to be a state-of-the-art institution founded on the theory of moral treatment.

Moral treatment is an approach to treating mental illness that said people could be helped if they were treated with kindness and dignity and kept in clean, safe, and specially constructed asylums.

But this vision for the New York City Lunatic Asylum had dimmed almost immediately.

Financial constraints kept the asylum from being fully built and from the moment it opened, it was overcrowded.

There was a prison on the same island and inmates were used as guards for the asylum, which led to abuse.

There was little in the way of actual treatment.

Nellie knows all this, and as the ambulance wagon she is riding comes to a stop in front of the doors to the asylum, she looks around at her fellow patients.

They may not know the history like Nellie does, but they are obviously distressed to be here.

An orderly climbs onto the wagon and lowers Nellie to the ground.

She sees Tilly Mayard, still looking sad, and goes to her side.

Tilly tells Nellie that she's going to wait for her chance to escape.

A group of nurses quickly takes over and ushers Nellie and the other women inside their new home.

Inside the asylum, the nurses shout to each other and hurl questions at the new patients, and Nellie immediately feels overwhelmed.

The nurses rush the women through physical exams and then down to dinner, shoving and pushing and slapping them.

The food is terrible, and there's not much of it.

Nellie eats nothing.

Then, she and the other women are hustled back out into a sitting room.

In the sitting room, to Nellie's surprise, there is a piano.

Nelly has played since she was a child and it brings her comfort, so she sits down at the keys.

She plays the first few notes of Rockaby Baby, and from behind her, she hears a beautiful voice ring out.

It's Tilly Mayard.

Nellie smiles, and they finish the song together.

Tilly has a beautiful voice.

They do a few more songs together, and for the short period of time, it's like all the women forget where they are until a loud voice cuts through the music.

One of the nurses is shouting that it's bath time.

Nellie stops playing.

She doesn't know why, but here at the madhouse, the idea of bath time terrifies her.

A few minutes later, Nellie feels a hand thrust into her back and she stumbles into a filthy bathroom.

Several other women are lined up inside and more are pushed in behind her.

A group of nurses stands at the ready.

In the center of the room, a woman thrashes in the only bathtub, chattering incoherently.

A nurse pulls the woman out of the bath and snaps at the rest of the group to take off their clothes.

Most of the the women shake their heads, and one woman flat out says she won't do it.

The nurse says if the women don't get undressed, the nurses will do it for them.

Some of the patients start getting undressed, but Nellie still refuses.

Two of the nurses grab Nellie and pull off her dress.

And before she can do anything to stop them, they yank her slip up over her head.

Nellie covers herself, but the nurses won't let her.

They tell her to hurry up and get in the bath.

Nellie fights back the tears and rage she feels welling.

She gets into the bath the other woman just got out of and she's never felt water this cold in her life.

One of the nurses grabs a rough piece of dry soap and starts scrubbing her.

Someone dumps three buckets of water over her head, drenching her hair, and suddenly Nelly feels like she's drowning.

She shivers and gasps, and for the first time, she realizes that she must actually look insane.

The nurses yank Nellie out of the tub and instead of a towel, they hand her back her slip and tell her to put it on wet.

The last thing Nelly sees in the bathing room before she's dragged out is Tilly Mayard being dunked in the water.

Nelly begs a nurse to spare Tilly because she's sick but the nurse doesn't listen.

Nelly knows that in this moment she's just another patient and what she says means nothing.

That night, Nellie is put in a room alone to sleep.

She's locked inside and it's dark and cold.

She has no idea what time it is, but she's exhausted, so she climbs onto the bed and pulls up the scratchy wool blanket.

She's still wet from the bath and the blanket is too short to cover her, so she lays there freezing, unable to sleep.

Instead, she thinks about what would happen if there was a fire.

She and all the other women would be trapped and burned to death.

Nellie has come to the asylum because she believes that journalists have a duty to expose egregious flaws in the system, to uncover when institutions are using their authority to abuse everyday people.

When she set off on this mission, she thought that her intelligence and her convictions and her connection to the world's publisher Joseph Pulitzer will keep her safe.

But now, as she lays awake until dawn, she realizes she could die in the madhouse.

It's Nellie's second day on the asylum at Blackwells Island, September 27, 1887.

Nellie wakes up to the sound of pounding on the door.

She's barely opened her eyes when the door swings open and a nurse walks in.

The nurse gives Nellie a new hospital dress, which she quickly puts on.

But Nellie sees something in the nurse's hand that totally throws her off.

The nurse smiles, holds up a large straw hat, and puts it on Nellie's head.

Nellie is so stunned that she just stares at the nurse and follows her out.

In the hall, Nellie sees all the other women wearing big straw hats just like hers.

As if on cue, they look at each other and start laughing.

The nurses and orderlies get everyone quiet and lead the women out of the building.

After a day in the dark asylum, the sun blinds Nelly, but the light feels good on her face.

The nurses tell the women to form a line and Nelly quickly finds her way to Tilly.

Tilly looks paler and more worn down, and Nelly hopes the sun and fresh air will help her.

But Nelly's hopes for a healing morning are quickly dashed.

The women follow the nurses across across the grounds and Nellie sees about 15 doctors and other men in suits gathered at different spots outside.

She sees them talking casually and pointing and laughing at another line of women who are also out walking.

But unlike Nelly's group, these women are bound at the hands.

Some are in straitjackets and they're all connected to each other with a long rope that is tied to hooks on their belts.

One woman with an injured leg is being pulled behind the others in a rolling iron cage, and several of these women are shouting prayers or curses at the top of their lungs.

Nelly turns to Tilly and asks who they are, but Tilly doesn't know any better than she does.

Then, one of the patients leans in and says those are the women from a different building of the asylum, the building that houses the violent insane.

This is when Nelly realizes that the women are being paraded around for these men like they're a sideshow attraction, a form of entertainment for the people who are supposed to be caring for them.

And this is nothing new.

The idea of patients and mental institutions serving as entertainment had existed for hundreds of years.

Doctors and members of the public alike treated these institutions like a carnival sideshow.

Even into the 1800s in England and the United States, asylum tourism was a legitimate pastime for wealthy people.

where they could observe these poor souls and perhaps donate a bit of money.

By 1887, when Nellie is watching the parade on the grass, asylum tourism has largely fallen out of favor, but the attitudes behind it have lingered.

In fact, in recent years, the staff at the New York City Lunatic Asylum has allowed newspaper reporters inside to write regular, mocking columns about the patients and their delusions, treating them like characters in a show.

The parade disgusts Nellie even more than being forced to get naked for a freezing bath.

Her attention lands on an old woman with long gray hair who is having an animated conversation with nobody.

Nellie wonders how long this woman has been here and what she was like when she arrived.

As angry as Nellie is, she keeps watching, so the image will be burned into her mind.

Nellie has no notebook or pencil.

The nurses took them before she even got to the island.

She's trying her hardest to remember everything, to write in her expose at the newspaper.

But every day in the asylum is the same.

Terrible food, degrading baths, meeting with uninterested doctors, and the parade.

The drudgery is interrupted only by violence.

The staff beats and chokes any woman who steps out of line or who dares to suggest she doesn't belong here.

Nelly starts to lose track of time.

The horror doesn't keep her sharp.

It does the opposite.

She feels herself being lulled into a terrible routine.

And she starts to understand that's the point.

The madhouse crushes any hope that change is possible.

It's five days after journalist Nellie Bly arrived in the asylum, October 1st, 1887.

Nellie walks down the hall as she does every morning when she wakes up.

But today, she sees Tilly Mayard sitting alone on a bench, and Tilly cannot stop shivering.

Everyone in the asylum is cold all the time, and the nurses refuse to give anyone more clothing.

But Tilly is physically weak from her untreated illness, and Nellie knows her body can't take much more.

Nellie runs to Tilly and rubs her arms and shoulders, trying to warm her up, but it's not working.

Tilly starts shaking faster and harder, and her teeth chatter.

Nelly looks up and sees orderlies and nurses sitting at a table nearby.

They can clearly see what's happening, and they're not even moving.

Nellie stands, looks right at them and shouts that they can't lock people up and then freeze them, but no one gets up to help.

Nellie turns back and Tilly starts convulsing.

She jerks her body and falls off the bench, but Nellie catches her before she hits the floor.

She holds Tilly in her arms and tries to calm her down.

One of the nurses finally comes over, looks right at Nellie and says, let her fall to the floor.

It'll teach her a lesson.

Nellie stays with Tilly, because she knows that no one else will.

After her seizure, Tilly Mayard starts to change.

At first, Nellie thinks that Tilly just doesn't want to talk, but soon, Tilly starts getting angry at Nellie every time Nellie comes to check on her.

Finally, one night, Nellie finds Tilly sitting alone on the same bench where she'd found her just a couple of days before.

Nellie sits down next to her and gives Tilly a warm smile.

And that's when Tilly screams.

She begins talking nonsense, saying that Nellie is trying to erase her because Nelly wants to become her.

Nellie stands up and stops herself from crying.

Only a few days ago, Nelly had played the piano while Tilly sang.

They had long conversations with each other about how Tilly was sane and how she wanted to escape.

Now, Nelly barely recognizes her.

And she realizes that the madhouse itself had broken Tilly.

and turned her into the thing the doctors said she was.

They took a scared woman who just needed medical care and drove her insane.

It's 10 days after Nellie Bly was admitted to the New York City Lunatic Asylum, the morning of October 5th, 1887.

Nellie steps out of her room and hears someone howling.

She follows the sound and sees a half-dressed woman lumbering down the hall.

In a thick Irish accent, the woman shouts, Three cheers, I have killed the devil.

Things like this barely phase Nellie at this point, and that frightens her.

She shouldn't have gotten used to all of this in such a short time.

She understands now that the asylum is a rat trap.

It's easy to get in, but almost impossible to get out.

Ever since she arrived, Nelly has acted as sane as she is, and she has made it a point to ask every doctor to test her sanity.

But the doctors have told her that her sanity itself is a delusion.

To the doctors, The very fact that Nelly says that she's sane is proof that she isn't.

Nellie knows that if she didn't have someone outside the asylum to vouch for her, she would be stuck here forever.

Later that day, a lawyer from New York City arrives on the island.

He says Nellie has friends who are willing to care for her.

She is being released.

Nellie knows her friends are really her colleagues at the world, Mr.

Pulitzer and her editor.

When the asylum staff tell Nellie she can go, It's the moment she thinks she's been waiting for.

The madhouse is a horrific place, and Nellie has been hungry, cold, and and abused here.

But as she walks off the island toward the boat and the lawyer waiting for her, she feels a pang of sadness and guilt.

She can see the women she has been imprisoned with taking a walk.

Tilly Mayard is there, looking lost in her own mind.

For a moment, Nellie doesn't want to leave Tilly or the other women behind.

After all, for the last 10 days, she's been one of them.

But the impulse to stay passes quickly.

Nelly climbs onto the boat.

She can fight for her friends by by writing about their suffering, not by joining them.

It's one day after Nellie's release from the New York City Lunatic Asylum on Blackwell's Island, October 6, 1887, at Nellie's home.

And Nellie is going without sleep again.

But this time she's writing her first report on her experience in the asylum and she feels a rush of adrenaline.

She writes an overview of her time on the mat house, highlighting the worst conditions and violence she witnessed, and images from the last 10 days come flooding back to her.

Even events that took place when she was overwhelmed or in a daze appear crystal clear in her mind, and she is able to write faster than she ever has in her life.

The following day, she submits her first report to her editor and to the paper's owner, Joseph Pulitzer, and they're both blown away.

Pulitzer is so excited that he tells Nelly to sign her name to her work because she's going to get a byline when it's published.

This stuns Nellie.

Journalists getting their name on stories is almost unheard of at the time.

It's a privilege usually reserved for famous people who write guest columns.

Nellie thanks Pulitzer, then heads home.

She's not finished with her story.

Nellie's first report is published in the world as Behind Asylum Bars on October 9th.

only four days after her release.

From there, things move fast.

Nellie writes a longer story, and the world runs it on October 16th under the headline, Inside the Madhouse.

America is shocked and enthralled.

The story immediately gets picked up and syndicated in newspapers across the country.

It's all anyone is talking about.

Just two days later, Nellie is summoned to speak before a grand jury in New York, and she testifies about the horrors she saw on Blackwell's Island.

Soon after, Both of her stories are set to be published as the book 10 Days in the Madhouse.

Even with all of the attention she's getting, Nellie has no idea if her work will make a difference.

But a month after returning home, in November of 1887, Nellie gets incredible news.

She learns that her writing, along with her grand jury testimony, has led directly to an $850,000 increase in New York's budget for mental institutions.

That's over $28 million today.

But that's not the best thing that happens, because Nellie learns that her writing has also led to the release of several of the women she met in the asylum.

Unfortunately, she can't save Tilly Mayard.

Tilly may have come to the asylum sane, but the asylum had destroyed her.

And although Nellie advocates for Tilly in her articles and later her book, Tilly is lost to the system that Nellie had fought so hard to expose.

Tilly Mayard will never make the escape she had planned.

This gives Nellie's success a bittersweet feeling.

But the media storm that Nellie kicks up is long-lasting.

Her work puts Bellevue Hospital and the New York City Lunatic Asylum, as well as all mental health institutions throughout the country, under enormous scrutiny.

By 1894, the New York City Insane Asylum is closed for good.

Slowly and steadily, more reforms lead to more funding, more oversight, and higher standards of treatment for all patients everywhere.

But mental health care is not the only institution that Nellie changes forever.

Nellie Bly set out to expose the truth and fuel reform in America's so-called lunatic asylums.

And in this, she was successful.

But her undercover reporting mission had a second and perhaps even longer lasting effect on America.

Because Nellie didn't just shed light on some of the massive problems in the country's mental health industry, She also revolutionized journalism itself.

When Nellie went undercover at the asylum, there was no such thing as investigative journalism.

Most major American publications, including the world where Nellie worked, were content to produce political propaganda and sensational crime stories in order to sell more papers.

But when Nellie met publisher Joseph Pulitzer, who would go on to establish the Pulitzer Prizes, he recognized the excitement inherent in the idea of sending a young, attractive woman undercover into danger.

And Nellie recognized that her status as a young woman, which so far had only held her back in journalism, was a perfect disguise, which allowed her to do the kind of hard-hitting reporting she had always dreamed of.

10 Days in the Madhouse made Nellie an American hero, and it quickly gave rise to a type of reporting people at the time called muckraking, or stunt journalism.

But what some critics have considered a cheap stunt in Nellie's time eventually became regarded as groundbreaking reporting.

Today, Nellie's work is recognized as laying part of the foundation for the investigative journalism that routinely appears on the pages of the New York Times, the Wall Street Journal, the Washington Post, and countless others.

Turn on the news or open a newspaper today, and you can see the impact of Nellie Bly's 10 Days in the Madhouse.

From Ballin Studios, this is a twist of history.

A quick note about our stories.

They're all heavily researched, but some details and scenes are dramatized.

A Twist of History is hosted by me, Joel Blackwell.

Executive produced by Mr.

Bollin and Zach Levin.

Our head of writing is Evan Allen.

Produced by Perry Crohn.

This episode was written by Karis Pash Cooper.

Story editing by Mike Federico.

Sound design and audio mixing by Colin Lester Fleming.

Post-production supervision by Jeremy Bohm and Cole LaCasio.

Research and fact-checking by Abigail Shumway, Camille Callahan, Evan Beamer, Alex Paul, Patricia Nicole Florentino, Calvin Riley-Holgate, Matt Gilligan.

Production coordination by Samantha Collins and Avery Siegel.

Artwork by Jessica Cloxton-Kiner and Robin Vane.

Thank you for listening to A Twist of History.

And we're back live during a flex alert.

Oh, we're pre-cooling before 4 p.m., folks.

And that's the end of the third.

Time to set it back to 78 from 4 to 9 p.m.

What a performance by Team California.

The power is ours.