In fact, Brown enthusiastically recommended the practice as an alternative to marital separation—in his book, Elizabeth would likely have been a prime candidate for cutting—and concluded emphatically, “Daily experience convinces me that all unprejudiced men must adopt…the practice which I have thus carried out.”40
Luckily, not all doctors did. “Would anyone strip off the penis…because [a man] was a moral delinquent?”41 one dared ask. In time, Brown was expelled from the Obstetrical Society of London, but not for performing the operation per se, rather for doing so without consent. Although his publication at first raised scandal, after the fuss died down, the operations continued, alongside surgical removal of the ovaries, which was another standard treatment for female insanity at the time. One superintendent was accused of the “mutilation of helpless lunatics”42 through his surgical work, but he continued regardless until his death in 1902. In fact, such practices continued long into the twentieth century. Archives show that clitoridectomies to correct “emotional disorder”43 were performed as late as the 1940s.
The last recorded case was on a five-year-old girl.
McFarland may not have employed clitoridectomies to control his patients, but he did use drugs, spending $749.30 （about $23,000 today） biennially on them. Recommended treatments of the era included opium and blue mass （a mercury-based medicine）， the poisonous “tincture of veratria,”44 a concoction of quinine, arsenic, and port wine, and straightforward cannabis. Yet the medicines available were so untested that at times, the doctors themselves would take one “for the purpose of ascertaining its effects.”45 One such doctor reported that after imbibing conium—a then-standard medicine for treating the insane, which is related to the poison hemlock—he developed double vision and a “singular sensation in the knees, which rendered it quite impossible for him to go upstairs without assistance.”46
Given the doctors’ need to impose control, many used narcotics to keep patients quiet. Chloroform and ether were particularly effective on “boisterous”47 women and therefore used to quiet them “not only temporarily but permanently.”48 One superintendent confided of chloroform, “I use it most on the female side of the house.”49
It was a declaration with which many doctors concurred, but McFarland was not publicly among them. Nonetheless, his patients’ claims that the doctor was abusive followed Elizabeth whenever she walked outside: a slow drip-feed of doubt that settled on her skin like rain. Though she defiantly continued to hold her prayer meetings on Seventh Ward—ignoring Mrs. Hosmer’s warning—the justified complaints of her friends that she heard there only added to her unease.
As she strolled about the grounds, it seemed someone was watching. Although Elizabeth obeyed the order not to speak to the lower ward patients, their voices carried all across the lawn. Someone somewhere decided additional action was required. One day, Elizabeth wandered outside to find the paradisiacal peace had been shattered by a most industrious banging of nails and voluminous sawing of wood. A solid board fence was being erected directly in front of the lower ward windows.
Day by passing day, the fence grew longer until it encircled the entire asylum. To her distress, Elizabeth found it reminded her that despite being the asylum favorite, she was still a prisoner. The fence was eight feet high and deliberately planked on both sides “to prevent its being scaled from within, and relieve its unsightly appearance from without.”50 But the double planking couldn’t conceal its innate ugliness, nor the truth of what it was: a wall that divided the world into them and us.
Elizabeth knew she was on the wrong side of it.
It agitated her. It reminded her that it had been weeks since she’d heard from Toffy. Though she believed the Blessings had all but forgotten her, she could not think the same of her son. She would not.
Her faith was rewarded. One day, in late summer, she happened to be in McFarland’s office when she noticed a letter lying on his desk. She’d have known that handwriting anywhere; after all, she’d helped teach her son how to make those shapes. As the letter was addressed to her, Elizabeth seized it with an exclamation of excitement.
Smoothly, McFarland snatched it from her. One moment, the letter was there, the next gone: a magic trick that had no payoff. Elizabeth, perhaps laughing at what she hoped was playful intervention, protested, but he did not return the letter. When she demanded to know what it had said—for it had clearly already been opened—the doctor point-blank refused to say.