The two most elegant and prestigious buildings in Towson are known simply as A and B.
No fancy names were necessary for the identical twins perched atop a wooded ridge at Sheppard and Enoch Pratt Hospital. With their six-story towers, lattice-work balconies and majestic bay windows, they spoke for themselves. One was built for men, the other for women. Both were hailed as part of the movement toward more humane treatment of the mentally ill in 1891.
Those days are long past.
In the world of managed health care, the 14-foot ceilings, Tiffany stained-glass windows and cozy sun rooms no longer fit.
Over the next few years, officials at Sheppard Pratt plan to build a more modern facility on the west side of the sprawling 100-acre campus -- closing two of the nation's oldest buildings still in use at a mental institution.
"It is one of the most significant buildings in America," says Carol Allen, president of Historic Towson Inc. "In some ways, it was like a huge cruise ship or hotel. It had its own china and silver, and was constantly redecorating the furniture inside. It is one of the best-preserved psychiatric hospitals from the 19th century."
Sheppard Pratt, one of the nation's top psychiatric hospitals, now handles nearly 6,000 inpatient admissions a year -- compared with just 53 in 1892. Still, there is less and less need for all the space in A and B, which are about as long as the warehouse at Oriole Park at Camden Yards.
Managed care and new drug treatments have brought about quicker assessments, daytime hospitalizations and community-based clinics to care for patients. Years ago, Sheppard Pratt patients were hospitalized for years at a time; now, the average stay is eight days. Over the years, Sheppard Pratt trimmed its hospital beds from 322 to 170.
"The fact that these buildings are still running is a labor of love," says Dr. Steven S. Sharfstein, Sheppard Pratt's chief executive officer and medical director, as he walks through the winding corridors of A and B. "But speaking in terms of modern science, these buildings no longer work. They are inefficient."
None of the rooms has private bathrooms or closets. Ornate fireplaces -- 130 of them -- in most rooms were rendered useless with central heating. Crossing from A to B is impossible without going through the attic or basement, or navigating a maze of locked doors. With 50 to 75 rooms on each floor, there are hundreds of places for patients to wander and hide.
With every year, A and B became more outdated, say hospital officials, who want to renovate the buildings and lease them as office space.
But the fate of the two is being watched closely by preservationists. A and B were designated national historic landmarks in 1971, along with the Swiss chalet-like gatehouse at the hospital's Charles Street entrance.
"Anyone who knows and loves architecture falls in love with A and B," says Judith Kremen, executive director of the Baltimore County Historical Trust. "They are the focal point of that campus."
Tree-lined roads curving this way and that take visitors to the top of the hill, where trees, shrubs and gardens surround the Victorian Gothic buildings designed by Calvert Vaux, who was also an architect for New York City's Central Park.
The hospital's founder, Moses Sheppard, a Baltimore Quaker and philanthropist, set out years before his death in 1857 to improve conditions for the mentally ill.
At the time, institutions for the mentally ill consisted largely of almshouses where men and women were crowded into narrow cells and chained to the floor. Little fresh air or sunlight reached the ill, who were often considered possessed by the devil.
Sheppard left a set of explicit instructions and his entire estate -- then a whopping $571,440 -- to a board of trustees. He told them to use only the interest from the estate to build the facility and demanded that "courteous treatment and the comfort of all patients" be given utmost importance in plans for the buildings, grounds and medical care.
He also insisted that patients must never be locked in a basement, but treated in spacious rooms with windows. Sheppard Asylum admitted its first patient on Dec. 6, 1891.
It had taken 38 years, 11 million red bricks and more than $3 million to realize Sheppard's dream. Several years later, Baltimore philanthropist Enoch Pratt gave the hospital $1.6 million. The only stipulation was that his name be added to the facility.
Allen and members of Historic Towson Inc. are trying to capture all this on film in a documentary about the 108-year-old institution.
Historic Towson members don't just want to bring the architecture of A and B to life. Through interviews with former patients and workers, they also want to tell the stories about a time when members of some of the South's most prominent families roamed its halls.
Hospital officials want to make sure that a more modern facility offers the quality of care found in A and B.
"Every day, we ask ourselves, 'What would Moses Sheppard think?' " says Sharfstein, the institution's fifth medical director. "He expected his asylum to do everything that science and compassion allowed to help the patient get better."