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Authors: Jane Kirkpatrick

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At an almshouse, a man who claimed to be a former local official clung to Dorothea, begging her to find release for him. “I am not insane. I am not insane. They leave me with that.” His eyes moved furtively to a body behind him so thin with hair missing in clumps. Dorothea thought the person might have died, but then she heard a swell of breath. Cockroaches skittered in a darkened corner. “I could be useful again, I could.” The former official’s eyes drained at the corners, and she could see that he was
closer to this world than the woman. Yes, a woman beside him hummed, then screeched. How dreadful his days must be.

“Why are you here?” Dorothea asked.

“I was unable to pay for a service and was taken to court. I cannot possibly repay from in here and will soon lose my mind if I stay longer. Please, please, help me.” He had sores on his hands, unhealed burns she thought. He reached out to her.

The laws of Leviticus came to her, the ones that warned that anyone who touched an unclean person would become unclean likewise. She took his hand, something her grandmother would have gasped at her for doing. The story of Mark was a stronger pull. Jesus touched a leper and healed him, a singular act of compassion.

The man gasped when she held his hand.

“Did I hurt you?”

“No, no. It … it’s been so long. Your touch …” His shoulders shook as he tried to quell the sobs.

Dorothea removed her gloves and put her pale palm against his and squeezed his fingers. “It’s the least I can do,” she whispered.

At another jail she spoke with a man who did not seem the least bit insane to Dorothea as she asked him what work he had once done.

“Livery, madam,” he said. “I tended stage horses until an injury required surgery and I healed slowly and could not pay.” When she asked the jailer about him, he described behaviors she would classify as mad. The jailer said the man was jailed, not just because he had failed to pay a bill, but because he had rushed out
into the cold. His family had been unable to keep him clothed or make any sense from him following his sentencing. Yet she had seen a man making perfect sense. Had that moment of appropriateness been brought on by her willingness to see what was normal in his world?

She lay awake that night considering his situation. In the morning she returned, seeking to have the man moved to a cell with fewer mentally ill persons. The resident doctor resisted at first but then complied.

“I see your point, Miss Dix,” he said. “The man has deteriorated. But we simply can’t move everyone around to suit you.” Dorothea thought he might be miffed because she had been able to get Dr. Howe to move a prisoner earlier.

She wrote a letter to Howe seeking possible employment for the man in the stables at the school. Perhaps she could find a place for him in a normal world. Moral treatment. For the first time it was not an abstract theory of how to treat people; it was a truth she had stumbled upon, one given her as she sought to relieve a man’s immediate suffering. Her touching him had seemed so small an act of kindness, and yet it brought out a response she would have herself if her hands were covered with sores, if she felt abandoned and alone and someone had reached out to her. As the Channings had. As the Rathbones had.

Dorothea sat up in bed and reached for her diary. Extending herself was the very thing keeping her from despair, from actually
becoming ill again. “To stay well, I must do this work. I must paint the portrait of what the human condition is like when left abandoned. There is hope for those prisoners. If I reach them, if I can make their lives more like mine, then I will have done good work. To relieve the suffering of others will relieve my own.” That thought startled her. “Moreover, if they see where my care comes from and that they can have it for themselves, then I will be meeting the Great Commission, to gather others to the heart of God where they need never feel alone.”

She would ask dozens of questions about what a normal person would experience: were Sunday school classes offered? Did the local Fragment Society come to teach needlework? Would a saddle maker be allowed to continue his craft? Did patients serve meals to others more impaired? Did they go outside, breathe fresh air? Were there uplifting books available for them to read, music to soothe them?

She would draw conclusions about the nature of those insane where normal opportunities existed. It would help prove the premise that a separate treatment hospital was needed. No bars or chains, their healing coming from the borders of compassion.

As she broadened her scope to include all of Massachusetts, Dorothea became accustomed to the stagecoach’s rough ride. She bounced and jostled and could not write, so she recorded in the evenings what she had encountered during the days. She tried to take notes in the jails, but she noticed the jailers offered only short
responses if she appeared to write them down. She strengthened her memory for detail, not just that which the patients said, but their jailers as well, pouring out the day on paper, using up nibs and ink in far greater numbers than she had imagined.

Through the stage windows she took in the countryside, the stone fences that marked one man’s border and spoke of efforts to clear ground and stack the rocks so they wouldn’t tumble down. She saw women in gardens and made a mental note to consider the size of a garden one might need for moral treatment in an institution housing two hundred fifty patients. Gardens would serve as treatment but also food supply.

At the stage stop where the horses were changed before travel to the next berg, Dorothea wondered about the care provided for work animals. Surely that was something normal. She watched the men pat the necks of the big animals as they lowered the heavy harnesses from them and led the horses to the trough. The fine animals lipped the water. She saw a bond between the men and beasts and thought of Mercy. She wished she had a dog or horse, some beating heart she might come home to in the evening. But this was wishful thinking. Her life was on the road now, and even when it wasn’t, she was in the home of another. What would she do with a dog when she traveled?

Instead, on a warm August evening she made a note about making sure the new institution Howe and she hoped for would have barns and sheds where patients could help the stockmen work with cows and pigs and chickens and horses. And where perhaps a small dog could be kept. Maybe more than one.

Before sending her material to Howe, Dorothea reread the Jarvis pamphlet on moral treatment. Jarvis had written it in the third person, as though someone else described his work. “Knowing that so much depends on the influences which surround the patients, Dr. J. regulated every thing in respect to its effect on them—their food, their exercise, the places and the persons they visited or who visited them, the conversation at table or elsewhere.” Most of all, he made a great case for doing away with heroic treatments, as they were known, the powerful herbs to put people to sleep, or the prescribing of painful treatments such as binding them with chains or shirts until blood stopped flowing to their arms, fingers, and feet.

She could see little difference between these heroics and torture. It seemed to her that Jarvis, too, felt that what governed all insanity were unchecked passions. She recalled a visit to a private home secured for the insane by a local sheriff. Inside, she witnessed unbridled passion unchecked as a man flailed and shouted and destroyed his meager belongings of which shards remained inside the room. But she felt his caretakers had intensified his behaviors by using brutal chains. Their violence escalated the man’s violence. That had to stop.
She
had to stop it. Somehow, she would.

Dorothea had thought Dr. Howe would rework her treatise and perhaps use it to support his review of Jarvis’s work for the
North American Review
article. Instead, Howe wrote an exposé on the
East Cambridge jail that was published on September 8, 1842, in the
Boston Daily Advertiser
. He reported that treatment “was disgraceful in the highest degree to a Christian community.”

The resident physician of the jail objected and wrote a response to the
Advertiser
, denying Howe’s charges.

Howe responded back, and others presented their perspectives with heated invective. A jailer gave Dorothea’s name and said she had barely been in his facility for five minutes and could not possibly have seen what was described.

“What on earth was Howe thinking?” Dorothea asked Anne. She poked at the newspaper article. “My material was to enhance his review of Jarvis’s work, not bring down the establishment on us. They’ll be reluctant now to let me in to see what’s going on.”

“Dr. Howe is usually so diplomatic, didn’t you say?” Anne knitted while Dorothea paced the room, causing the lamplight to wobble on its stand.

“I wanted this to bring a general awareness to people. Then approach legislators in particular with good evidence to back up what we want. Now the doctors and the jailers have their backs up. They see this as an assault on them rather than a cause to take different action. I never once said the jailers or the resident doctors were bad people!”

Had she misread Howe’s intention? Did he have an ulterior motive, raising his own prestige for his blind school at the expense of a systematic plan for reformed treatment for the insane?

“I must write to him. And to the
Advertiser
.”

She had to defend Howe’s statements if only to sustain her reputation as a benevolent observer. But if she did, she was making herself public. More public than she had planned. But for the sake of the mentally ill, she felt compelled to write a letter. She said that the conditions in East Cambridge were as Dr. Howe had described them, but they were also better than in other Massachusetts prisons she had visited. She promised to reveal more of what she had seen with the hope toward changing all of it, knowing that the jailers and others did the best they could. It was the responsibility of all the people of the commonwealth to aid them in saving the insane.

The
Advertiser
rejected her submission but the
Evening Mercantile Journal
accepted it for publication. Perhaps she could put water on this firestorm after all.

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