In 1887, four months after returning from Mexico, Nellie talked her way into Joseph Pulitzer's newspaper in New York City, and at only 23 years of age accepted an assignment to go undercover into the Women's Lunatic Asylum on Blackwell's Island posing as a mentally ill girl. The paper promised to get her out after ten days.
The first thing she had to do was convince the doctors at the asylum that she was truly insane. After practicing deranged expressions in front of a mirror she checked into a boardinghouse. Nellie refused to go to bed, telling the boarders that she was afraid of them and that they looked crazy. By the next morning they were convinced that she was the crazy one and called the police. She was taken to a courtroom and pretended to have amnesia. The judge was convinced Nellie had been drugged. After this, she was examined by several doctors who all agreed that she was most assuredly insane. "Positively demented," said one, "I consider it a hopeless case. She needs to be put where someone will take care of her." The head of the insane pavilion at Bellevue Hospital pronounced her "undoubtedly insane." The case of the "pretty crazy girl" attracted media attention. "Who Is This Insane Girl?" asked the New York Sun. The New York Times wrote of the "mysterious waif with the wild haunted look in her eyes," and her desperate cry, "I can't remember I can't remember!"
Nellie experienced all the horrors of the asylum first hand. The food consisted of gruel broth, spoiled beef, bread that was really just dried dough, and dirty undrinkable water. The dangerous patients were tied together with ropes. Nellie witnessed one gray haired woman being grabbed and dragged by the
hair as she shrieked and pleaded from the room, "For God's sake, ladies,
don't let them beat me." All the patients were made to sit for much of the day on hard benches with no protection from the cold. Waste was all around the eating areas. Rats crawled freely throughout the hospital. The bath water was freezing cold. Patients were treated obnoxiously and abusively by nurses telling them to shut up and beating then if they did not.
Nellie spoke with many of her fellow patients and was convinced that some were as sane as she was. She wrote, "What, excepting torture, would produce insanity quicker than this treatment? Here is a class of women sent to be cured. I would like the expert physicians who are condemning me for my action, which has proven their ability, to take a perfectly sane and healthy woman, shut her up and make her sit from 6 a.m. until 9 p.m. on a straight-back bench, do not allow her to talk or move during these hours, give her no reading and let her know nothing of the world or its doings, give her bad food and harsh treatment, and see how long it will take to make her insane. Two months would make her a mental and physical wreck." Nellie also wrote of bath time, "My teeth chattered and my limbs were numb with cold. Suddenly, I got three buckets of ice cold water dumped over my head. One in my eyes, nose and mouth."
At the end of the ten days an attorney for the newspaper came and got Nellie released from the asylum at The World's behest. Her reporting, which was later published in book form titled "Ten Days in a Mad House," brought Nellie her lasting fame. It also caused embarrassment to the physicians and staff of the hospital who would try to explain how so many professionals had been fooled. A grand jury launched its own investigation into conditions at the asylum, and asked Nellie to assist. The jury's report recommended the changes she had proposed, and its call for increased funds for care of the insane prompted an $850,000 increase in the budget of the Department of Public Charities and Corrections. They also made sure the future examinations were more thorough so that only the seriously ill actually went to the asylum.