At times, her treatment was harsh enough even to shake her faith. “While I have been here and seen and felt these horrors in my own soul,” she said, “I have been led to exclaim, ‘Is there a God? Can a just God behold and see these horrors, and let them go on?’”20 As an asylum inmate put it, “Human endurance is not made of India-rubber.”21 And under these conditions, Elizabeth found it harder and harder to bounce back.
She wondered what the doctor was playing at. She had been concerned before about the lack of treatment for those who were genuinely mentally ill, but this course he had now prescribed went the other way. As one patient put it, “Most of [the] doctors that are employed in lunatic asylums do much more to aggravate the disease than they do to cure it.”22 And another patient went further: “INSANE ASYLUM. A place where insanity is made.”23
As the calendar days started counting down through December 1860, Elizabeth came to the same conclusion. “I fully believe,” she said bluntly, “it was the Doctor’s purpose to make a maniac of me, by the skillful use of the Asylum tortures.”24
But Elizabeth was wrong. Totally wrong. McFarland was not trying to make her a maniac.
Because he already thought her one.
And he always had.
CHAPTER 19
“Her case is indeed an interesting study,” McFarland had written to Theophilus on August 11, 1860, “as showing a fine mind and brilliant imagination…and yet, all these mental endowments deep-dyed with the color of radical disease.”1
McFarland did subscribe to a school of thought that moral insanity existed only if attended by intellectual impairment. But he also believed this impairment or delusion could be invisible, with “no outward form of manifestation whatever.”2
In truth, it didn’t bother him that he had not yet found the intellectual delusion from which he believed Elizabeth suffered, because from the morally perverse conduct she’d already shown （such as her desire to live apart from her husband, even simply the way she’d stood up to him）， he did not doubt its underlying existence. He believed in it the same way he did gravity: he could not actually see the gravity when the apple fell to the ground, but that did not mean it was not there.
“When I have a case where there are strange, moral perversities, inconsistent with the previous character, conduct, education and habits of life of the person,” he said, “I have no hesitation in taking the position that it is insanity.”3
By this criteria, Elizabeth was a textbook case. After all, for twenty-one years, she’d maintained the habit of obeying her husband. To McFarland’s mind, her evolution from submission to self-possession was classic madness. He did not think, as Elizabeth did, that the change in her behavior was due to “a natural growth of intellect.”4
In addition, although Elizabeth had emphasized to the doctor that her aversion to her husband was based on logic—because of the way he’d treated her—McFarland believed that baseless. Thus he would consider her as having an “absence of…the instinct of love as found even in the lower orders of animals,”5 which was more proof she was sick.
A peer of McFarland confirmed that her behavior met the threshold for intellectual insanity, even if the delusion was unseen. “Apparently motiveless conduct is always suspicious,” he wrote. “An unreasonable fancy…that there is a conspiracy against [the patient is] one of the most frequent maniacal fancies when the intellectual development of the disease has been reached.”6
And what better example of motiveless conduct than Elizabeth’s supposedly irrational hatred of her husband? Her accompanying charge that Theophilus had conspired to lock her up in McFarland’s asylum when she was sane scored an A grade for “maniacal fancy” too.
McFarland was not alone in happily committing patients with invisible insanities to his hospital. It was almost standard practice. At the meetings of the AMSAII, superintendents rather raced with enthusiasm to share stories of inmates who exhibited “no positive trace of disease for weeks or months together.”7 Interred at asylums, such patients would, for months and sometimes even years, “work, talk and seem to feel and think as other people.”8
Often—as had happened with Elizabeth—the friends and family of such patients might protest they were not insane and should immediately be released, but in these cases, the doctors remained adamant that they were right. They would assert arrogantly that “insanity has its own delicate characteristics…which can be read by the expert, but which are not appreciable to the casual observer.”9 They airily promised these doubting family members that they would see the doctors’ greater wisdom. Just give them time.