Late on the night of March 10, 1948, a fire started in a kitchen of the main building of Highland Hospital in Asheville, North Carolina. Spreading rapidly through a dumbwaiter shaft, flames reached every floor, and, in spite of efforts by hospital staff and local fire fighters to evacuate everyone from the building, nine patients died. Among the victims of the fire, identified only by her slipper, was Zelda Fitzgerald, who with her husband, the writer F. Scott Fitzgerald, represented for many the talent, sophistication, glamour and excess of American life of the 1920s.
Highland Hospital, originally known as “Dr. Carroll’s Sanatorium,” was founded in 1904 by Dr. Robert S. Carroll, a distinguished psychiatrist. His program of treatment for mental and nervous disorders and addictions was based on exercise, diet and occupational therapy, and attracted patients from all over the country. The hospital was relocated from downtown Asheville to the northern end of Montford Avenue in 1909, and was officially named Highland Hospital in 1912. Dr. Carroll gifted the hospital to Duke University in 1939.
In 1928, Zelda Fitzgerald had decided to pursue a lifelong dream of becoming a professional ballerina, and had begun taking lessons in Paris from a famous dancer. But at that late age (she was born in 1900), three years of intense eight hour a day ballet work damaged her health, and prompted her first mental breakdown, diagnosed as “nervous exhaustion,” in 1930. On May 22, after hearing voices and exhibiting delusional behavior she entered a clinic in Switzerland. On June 5 she entered another hospital near Geneva, Les Rives de Prangins. At Prangins she was diagnosed by Dr. Oscar Forel as schizophrenic.
Zelda would reside in and out of hospitals for the rest of her life.After she was released from Prangins on September 15, 1931 she returned to the United States. On February 12, 1932 she entered the Henry Phipps Psychiatric Clinic of the Johns Hopkins University outside of Baltimore. During her stay there, she wrote her first and only novel: Save Me the Waltz, which was an almost autobiographical account of her life up to that point.
Zelda’s creative output also included a play, Scandalabra, several short stories and articles, and a large number of paintings, paper dolls, and sketches—some of which were intended to be passed on to her daughter and grandchildren. She began a second novel in 1942, “Caesar’s Things,” which was never finished but which covered ground similar to her first book.
In April, 1936 Zelda checked herself for the first time into Highland, where she remained until April, 1940. By then estranged from Scott, she instead headed back to her childhood home in Montgomery, AL to live with her mother. She sought out Highland once more in August 1943 for a six month stay, again in early 1946 through the end of that year, and checked in for what became her final stay in November 1947.
Mary Porter worked at Highland and was involved in Zelda’s treatment. She described that experience in an interview with Zelda’s biographer, Nancy Milford:
We were very careful with Zelda; we never stirred her up. She could be helped, but we never gave her deep psychotherapy. One doesn’t do that with patients if they are too schizophrenic. We tried to get Zelda to see reality; tried to get her to distinguish between her fantasies, illusion and reality. This is not easy for a schizophrenic. The psychotherapy was very superficial…She often rebelled against the authority, the discipline…She didn’t like discipline, but she would fall into it.
Dr. Irving Pine, Zelda’s last psychiatrist, believed (too late) that she may have actually had severe untreated bipolar disorder. He speculated after her death that the cause of her breakdowns may have been as much from her husband’s mental bullying and her treatment for her disorder as the disorder itself.
Bryer, Jackson R. & Barks, Cathy W. (eds.). (2002), Dear Scott, Dearest Zelda: The Love Letters of F. Scott and Zelda Fitzgerald, New York: St. Martin’s Press