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Dorothea Dix: magnificent monomaniac


"Voice for the Mad: The Life of Dorothea Dix," by David L. Gollaher. 538 Pages. New York: The Free Press. $28

Imagine a biography of a medical pioneer, a doctor treating heart disease in the 19th century, for example. Safe in our armchairs, we could read the history with a certain smugness, a heart-healthy glass of red wine at the ready and a state-of-the-art emergency room a phone call away.

Perversely, I yearned for such a book while reading "Voice for the Mad," the thoughtful new biography of Dorothea Dix - and one of the most depressing books I have read in years. The fault lies not in Dix's inspiring legacy, which deserves the scholarly and respectful treatment accorded by David L. Gollaher, but in society's failure to build on that legacy. Prodigiously researched, this is a book primarily for those who bring a passionate interest in the subject, yet its straightforward style makes it accessible to casual readers as well.

Page by page, "Voice for the Mad" underscores the United States' ambivalent attitudes toward the indigent mentally ill, and the erratic progress in their treatment. In 1995, we are asking the same questions Dix faced late in her career as a reformer. What do we do with incurable patients? Should they be in institutions, draining resources away from others, or should they be released to wander the streets? Isn't there a cheaper way to care for the mentally ill?

Dix began simply, with the revolutionary notion that the insane deserved humane treatment. A Boston spinster who had enjoyed modest success as a writer of children's books, she was horrified when she saw people chained inside Massachusetts jails, madness their only crime. She took her crusade from state to state, spearheading a national asylum movement. She helped to push a federal bill through as well, but President Franklin Pierce vetoed it. If the government had to care for the indigent insane, the president reasoned, what would keep it from taking responsibility for all poor people?

"The poor weak President has by an unprecedented extremity of folly lacerated my life," Dix told a friend. She was angry, disillusioned and personally wounded, for her ego was bound up in her good works.

Mr. Gollaher understands the complicated natures of seeming saints, and his clear-eyed view of Dix gives "Voice for the Mad" its bite and perspective. He never lets a reader forget there is a person behind the crusade - an unusual woman, contradictory and imperfect. Monomaniacal, she considered no cause as important as her own, not even the anti-slavery movement.

She also understood her solutions were imperfect at best. The new asylums she helped to create beget new abuses. "Clearly and unmistakably, the nation indicated that it wanted the insane to vanish," Mr. Gollaher writes. "Just as plainly, it signaled that it wanted to effect their disappearance as cheaply as possible."

It seems we can remember history and still be condemned to repeat it.

Laura Lippman, a features writer at The Sun, has been a reporter for 14 years. In 1988, she joined The Evening Sun as its social service writer. She has written extensively about Baltimore's homeless and indigent.

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