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a Bellevue stay, went straight to the pier to jump off it. Bly was now a woman without relatives to protect her, exiled from mainstream society. A doctor saw her (feigned) distress and offered to accompany her to the office, where he turned in her paperwork. But when she was sent to the insane ward, and a burly man dragged her away, the doctor, despite her pleading, said he was needed at an amputation and left.

After evaluating Bly, Bellevue doctors remained puzzled. Maybe she had been drugged or suffered from depression or melancholia. At least one, though, determined she had “hysterical mania.”

With this diagnosis, the doctors tapped into a centuries-long debate over women’s health. Based on an ancient malady, cited by Hippocrates and Plato and centered on the notion of a “wandering womb” afflicting various parts of the body where it settled, hysteria in the second half of the nineteenth century had evolved into a unique strain. Symptoms included fits, nausea, vomiting, headaches, self-centeredness, sadness, laughter, depression, and yawning. Subcategories encompassed “neurasthenia,” or nervous exhaustion; “green-sickness,” which today might be recognized as anemia or anorexia; “nymphomania,” which struck, in particular, the small, dark, and buxom, as well as young widows and women married to cold men who lacked vigor. Hysteria’s risk factors included taxing the intellect, “the sight of licentious paintings,” “frequent visits to balls or the theatre,” “the too assiduous cultivation of the fine arts,” and living in cities. The most popular treatment had been dreamed up by Dr. Silas Weir Mitchell, who advocated bed rest without any distractions (like books), forced feeding, and electric shocks.

Easy to diagnose, yet impossible to define, the only sure thing about hysteria was that the primary risk factor was being female. Sometimes, that in itself was enough. “As a general rule, all women are hysterical and . . . every woman carries with her the seeds of hysteria. Hysteria, before being an illness, is a temperament, and what constitutes a temperament in a woman is rudimentary hysteria,” claimed one physician. The nature of their bodies made sufferers unreliable.

Other doctors acknowledged, though rarely in so many words, that the problem was sexual frustration, the struggles of a female body straitjacketed by Victorian ideals of femininity. Cures included pelvic massage, spraying upper thighs with water, and, when the technology developed, the application of vibrators to “dissolve the paroxysm.”

But the patients receiving these treatments were the lucky ones, mainly wealthy, mainly white. Others ended up in the asylum. Like Nellie Brown.

On the boat across the East River, in a dirty cabin, accompanied by attendants who spit tobacco juice on the floor, Bly took note of the other women consigned with her to Blackwell’s Island. Tillie Mayard, a frail twenty-five-year-old with short hair who was recovering from an illness, stood out even at Bellevue. She seemed sane enough, just sick. Mayard thought friends were sending her to a convalescent home to recover from a “nervous debility” and was devastated to find out where she was going. Bly would keep an eye on her.

On shore, an ambulance took them along the river road, past sparse trees and a reeking building Bly determined was the kitchen. The L-shaped asylum itself, enormous and stark, was built of pale stone quarried on the island. Once again, Bly feared her performance skills might let her down. When she walked into Blackwell’s grand hall, marked by a twisting staircase, her goal in sight, she wanted to shout in triumph. Seeing her expression, Mayard commented, “I can’t see what has cheered you up so. . . . Ever since we left Bellevue you have looked happy.”

“Well, we might as well make the best of it,” Bly replied.

The first night, Bly eavesdropped as Mayard pled her case, asking doctors to test her for insanity, only to be ignored. Attendants slapped the newcomers, fed them bread with rancid butter, roughly bathed them in icy water in a cold room. In a more cheerful moment, Bly played “Rock-a-Bye Baby” on an out-of-tune piano, and Mayard sang along. Mayard plotted escape, telling Bly she would be obedient until she could make a plan, but the next morning confessed that, after a sleepless night, “My nerves were so unstrung before I came here, and I fear I shall not be able to stand the strain.”

Settling into the asylum, Bly met many patients, like Mayard, who didn’t strike her as insane at all. One immigrant woman with little English was locked up by her husband, according to the nurses, “because she had a fondness for other men than himself.” Another, who described herself as “penniless” with “nowhere to go,” had asked to be sent to the poorhouse but ended up at the asylum instead. A third, a young cook, had been committed after she lost her temper when someone dirtied the floor she’d just finished cleaning.

Immigrants, the poor, the adulterous, the angry, the sick. Like hysteria, the asylum seemed like a catch basin for women society didn’t know what to do with.

Once inside Bly stopped acting “crazy” at all. It wasn’t necessary. Despite Mayard’s requests for evaluation, doctors paid scant attention to the patients. “How can a doctor judge a woman’s sanity by merely bidding her good morning and refusing to hear her pleas for release?” Bly asked one doctor. She concluded, “Even the sick ones know it is useless to say anything, for the answer will be that it is their imagination.”

In fact, the place seemed designed to turn sane women crazy. When nurses whisked patients out of sight, Bly gathered evidence of violence on their return: black eyes, choke marks on throats. And she hadn’t even seen the worst, deciding that she wouldn’t try to get into the Lodge and the Retreat, which housed the most violent prisoners. Her bravery had its limits. Noting that women were locked in their rooms with individual locks, a death sentence in a fire, she suggested to the assistant superintendent they install universal locks, like those in prisons, so all doors could be opened with one switch. He just

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