The Best Specimen of a Tyrant: The Ambitious Dr. Abraham Van Norstrand and the Wisconsin Insane Hospital

11. “The Usual Little Jarrings in the Ward”

E L E V E N The Usual Little Jarrings in the Ward The superintendent and his assistant charted in enormous casebooks, a fresh page for each newcomer. If he proved to be an attentiongetter and stuck around long enough, that page eventually filled, and he reappeared deeper in the book and perhaps even in a subsequent casebook, like a magazine serial that went on forever. But few patients took up more than a page or two. Given the many demands on the two physicians, patient records simply were not a high priority. A new arrival came to life in the casebook only after a period of observation. The first note included background information from the application form, a physical assessment, a summary of his initial adjustment to hospital life, and any medications, special diet, or other treatments prescribed. Months, even years, might pass before the next entry. Serious illness, dramatic upsets, sustained periods of improvement or decline met the casebook threshold, but lives of quiet desperation tended to go unrecorded if not unobserved. The application usually arrived before the patient. It provided basic information—age, marital status, occupation, and so on—and posed questions intended to elicit a profile: Describe the symptoms. When did they first appear? Were there “permanent delusions,” or an inclination to attack others “from premeditation or sudden passion”? Had homicide or suicide been attempted? Was he “cleanly” in his personal habits? Were his parents blood relations, and were any relatives insane? Was he addicted to “intoxicating drinks, opium or tobacco, or any improper habits?” Doctors, jailers, and others with 146฀฀•฀฀The Best Specimen of a Tyrant scant knowledge of the person dashed off little that was useful, but applications labored over by family members were often richly detailed and moving, even if the writer was clearly ill at ease with the task at hand. “This is one of the outcroppings of the hellish Rebellion,” Van Norstrand wrote of a man whose son had died in a rebel prison.1 “Came in with very marked hallucinations, hearing spirits talk to him, etc. Was put on whiskey and quinine with nourishing diet.” At least Gilbert Wilson steadily improved, although after sending him home Van Norstrand worried that he would show up again. Wilson was among dozens whose madness had been triggered at least in part by the war.They included widows, wives tormented by returned veterans, mothers convinced that the draft was a death machine stalking their sons, fathers and mothers whose grief had driven them berserk or sucked all the vitality from them. And there were the soldiers themselves. One arrived shackled, “irritable, morose, disposed to violence,” and showing signs of secondary syphilis.2 Another, the former fife player from Van Norstrand’s old regiment, had been released from the Government Hospital in Washington where he had wasted away from the effects of nostalgia, obsessed with “liberating the Negro.” His wife had refused to take him in, and so he showed up at the hospital.3 Some had suffered head injuries—a fall from a horse, a blow of some kind, a glancing minie ball. A young German who had taken a bullet in the face went crazy in the Harvey House hospital across the lake and jumped through a third-story window “in fear of some approaching evil.”4 Nathaniel Foster was paralyzed with guilt, confessing to the murders of his cousin and a woman while in the army.5 When neighbors learned that James Dawson, a middle-aged veteran with four children, was in the county jail covered with filth and ranting about his many afflictions, they took up a collection and cared for him in a barn until the hospital could admit him.6 A statement from another veteran’s application might have been rubber-stamped on many: “Came home crazy.”7 At least most of the war-related insane got better. Probably they were assigned rooms on the upper two wards, where the most hopeful cases were housed. Those on the first floor were not so promising, among them many with progressive, organic conditions. The German wife of a tailor had spent time at the hospital during Clement’s reign, only to be readmitted and still in the house when Van Norstrand took over. Although run-down physically she carried on like royalty, ordering her servants about and expecting special treatment. “Her mouth had become gangrenous,” Clement wrote. “The offensive...