Festival O23: Opera Philadelphia presents Rene Orth and Hannah Moscovitch’s 10 Days in a Madhouse

“Some things—the dismissive attitude and bias towards women patients in the medical field, the mistreatment of immigrants and the poor, the lack of support for mental health—are all still very much the same,” Orth writes in the O23 playbill.

Journalist Nellie Bly (1864-1922; born outside Pittsburgh as Elizabeth Jane Cochran) became famous for one of her first assignments with the New York World. She feigned madness to gain entry as a patient to a mental institution on Blackwell’s Island (now New York City’s Roosevelt Island). She stayed for 10 days, and her reporting and subsequent book on the abhorrent conditions there led to major investigations and reform.

Now, her story is an opera, fluidly directed by Joanna Settle under conductor Daniela Candillari. Opera isn’t usually what I write about, but as a woman and a journalist who has spent time in psychiatric hospitals (not on assignment), I couldn’t miss this premiere.

The island asylum

Andrew Lieberman’s circular scenic design conspires with Hannah Moscovitch’s likewise non-linear libretto. The set perches onstage like a giant gray hatbox with the orchestra on top, and the ensemble swirls around it and sometimes through its bisecting hallway. It’s an apt evocation of the confining architecture of the institution as well as the circling theme: are the women inside “mad” because they are women, condemned by their own alienation, poverty, or grief?

The opera’s story opens near its close, with Nellie (soprano Kiera Duffy) on her last day inside the walls, perhaps succumbing to the cruelties she has witnessed. She says the nurses bruised her and tore out her hair. “That’s the darkness of your own mind,” replies Dr. Blackwell (baritone Will Liverman), peeling off a frazzled lock of Nellie’s hair with his hands. We go backward in time to witness Nellie’s days “On this / Island / In your asylum” and the risky ruse that got her there.

Music and fire

Orth’s score, in which the nonverbal sounds of the human voice are as vital as the other players, mixes ambient electronics with more traditional orchestrations for a sense of two worlds coming apart at the seams. A thump of the strings becomes a heartbeat, and a waltz slides into a creepy carnival tune. A choir of “madwomen” (Tanisha L. Anderson, Marissa Chalker, Veronica Chapman-Smith, Jina Jang, Meghan McGinty, Julie Snyder, and Kaitlyn Tierney) becomes an eddy of voices, a hymn eaten by a sly dissonance that dips and surges: funny and sinister, familiar and weird. Chris Sannino’s sound crisply captures every texture of the score.

In a highly physical performance, soprano Lauren Pearl menaces as a sadistic nurse. In the role of Lizzie, mezzo-soprano Raehann Bryce-Davis gives what is sure to be one of the most engrossing performances of the season. Duffy’s Nellie slides like a bow on the strings between self-assurance, grief, desperation, and righteous fire.

By the end, that fire lands on the audience: “The women I met in there / Most were not mad / They had no family / They were sick / Unlucky / Poor / Migrant,” Nellie tells us. “Help them.”

The “madhouse” today

Many modern psych patients can tell you that some things haven’t changed. We are the only sick people who are locked into the hospital, separated from our loved ones and every ordinary comfort: our shampoo, our music, our hobbies, our coffee. Nurses slash the cords and rivets out of our clothes and give them back to us, ruined, even though they no longer fit, flapping around us because we have nothing else to wear. We face harassment and constant startling intrusions, sometimes from other patients (in some facilities, experiencing things as varied as substance withdrawal, depression, mania, or violent psychosis all on the same ward), sometimes from doctors.

Some psych hospitalizations are necessary in extreme circumstances. Some facilities are more humane than others. But 10 Days in a Madhouse makes me remember many of the people I met there: a wife struggling with chronic pain and a heartless husband; people with obvious physical disabilities given little or no accommodation; people who were grieving deeply, including a woman whose boyfriend had been murdered only a few months ago.

Who are “they”?

It’s fitting that 10 Days is premiering in our region. As Jamie Ray-Leonetti (associate director of policy at the Institute on Disabilities at Temple University) points out in the playbill, Pennhurst (1908-1987) casts a long shadow in nearby Chester County. Ostensibly for people with intellectual and developmental disabilities, this state facility also cruelly confined immigrants and people who were poor or homeless or mentally ill, or even just women who were unmarried. Today, many disabled people are still fighting for their right to stay in their communities instead of stifling, isolating institutions.

In 10 Days, Dr. Blackwell forces Nellie to waltz with him, crooning about how she resembles his wife: “It soothes women to dance, I find.” How many degrading, poorly evidenced waltzes are people (especially women) in psychiatric or medical care still forced to do today? Are our stories moving backward?

“I’m mad they say but I don’t know,” Lizzie tells Nellie. More than a century after Nellie Bly left Blackwell’s Island, the cycle continues: who are “they”? And why do they get to decide who is sane?