The Worcester State Hospital offered a novel and compelling promise: that insanity could be cured by humane treatment in a therapeutic setting. Patients would enjoy its idyllic landscape, genteel interiors, wholesome food supplied from its farm, and the individualized attention of medical professionals. The hospital’s reputation as a model institution helped to position the city of Worcester as an economic center and pioneer in social reform. Yet overcrowding, insufficient funds, and the limitations of medical knowledge undermined the institution’s mission, leading to the abandonment of its original features. Despite downsizing and decay, the Worcester State Hospital continues to exert a tangible presence on the landscape. Its iconic clock tower, salvaged from demolition, stands as a reminder of its historical legacy and of the continuing role of the site–now the Worcester Recovery Center and Hospital–in the treatment of mental illness.