The Adelaide Brent Letters: Queer Care in Medical Correspondence

Nine years before the publication of Thomas DeQuincy's Confessions of an English Opium Eater (1821), a young woman named Adelaide Brent wrote a letter about her opium habit. The letter, dated 1 December and likely composed in Washington, DC, in 1812, was meant for Dr. Benjamin Rush, the most famous physician in the early United States. Brent's family and physicians had written to Rush detailing her opium use and questioning her sanity, so she sent her own letter to counteract their reports. This Feature introduces four letters from Rush's incoming correspondence, all of which concern Brent's health. During his long career as a physician in Philadelphia, Rush received letters from patients and physicians all over the East Coast. He participated in a robust network of epistolary medicine, which allowed physicians to share information while also inviting patients to actively participate in narrating their own experiences of illness (Knott 646, 674; Dauer 781–82). Brent was one of many people who wrote to Rush to ask for medical advice and to shape her own care. Although she sought Rush's assistance, Brent does not appear to have been interested in subordinating her own assessment of her behavior to his expert authority. She instead aimed to mobilize Rush's expertise in support of her self-assessment. In their content and context, Brent's letters offer us an opportunity to locate queer forms of refusal and care in medical correspondence. Brent powerfully revises discourses of independence and freedom to justify her opium use and her rejection of normative standards of behavior. The queer freedom she posits relies on her attachment to a female friend, whose letter of support legitimizes Brent's account and suggests a network of resistant homosocial care at work in early republican medicine.

The Brent letters are compelling because they record a conflict among Brent, her family, and her physicians. These letters offer a glimpse into the disputes around appropriate care and trustworthy observation that permeate medical practice in the United States in the late eighteenth and early nineteenth centuries. Letter 1 describes Brent as a woman whose "ambitious notions of Independence" have fueled her life-threatening opium habit (138). The letter describes Brent as "perverse," details her opium and laudanum usage and other objectionable behavior, and muses about how best to control her in the future (137). On first reading, this letter comes across as a devastating account of addiction, linked to conflicts about inheritance (Brent took control of her father's estate at a young age after her mother's death), the appropriate role of women in their families (Brent's father and brothers continually wrangle with her behavior), and the impacts of education (Brent's liberal education and high ideals are deemed partially responsible for her mental distress and substance abuse). Already, a strain of queer desire runs through this narrative of addiction and refusal, as the writer of this letter links Brent's prolific opium use to her rejection of normative expectations about gender and attachment. As this writer puts it, Brent's behavior is "elevated by her high and ambitious notions of Independence," which guide her conduct "in defiance of the disapprobation of her friends & the censure of the World" (138). Convictions about the ideal of independence and the power of desire supersede moral judgment.

Letters 2 and 3 shift this picture significantly, adding depth to the conflicts around self-determination, desire, and gender that are hinted at in Letter 1. Letter 2 is Brent's own letter to Rush, rebutting the narrative produced by her father, brother, and physicians. Brent outlines her experience of health, her use of opium, and her objection to the forms of evidence offered in the unsigned first letter. While Brent acknowledges her "distress" over the possibility of having committed an unforgivable sin, and her use of opium to assuage her "exquisite" suffering, she also maintains that she is a moral, socially fit, and rational person, fully in control of her opium usage and her behavior in the rest of her life (140, 141). Brent's letter is self-assured and insistent...