Mystery, Adventure, Gender, and Medicine

Sarah Swedberg

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If Nursing Clio were a work of historical fiction set in England in the early 19th century, it would be Alison Goodman’s The Benevolent Society of Ill-Mannered Ladies. In the background, the Napoleonic Wars (1803–1815) are raging and the war with the United States has just begun. In the foreground, Lady Augusta Colebrook, her twin sister Julia, and assorted other characters negotiate medical practices and gendered bodies. Contained within the covers are coverture, gender norms, humors, bleeding, laudanum, breast cancer, pregnancy, prostitution, sexuality, and madness. Other historical themes and topics also appear: enslavement and abolition, class, fashion, mourning, and even the window tax.

Goodman organized her novel around three intertwined cases of women’s captivity that Augusta, Julia, and a varied cast of characters tackle. The captivities are different from one another on the surface, but, on a deeper level, women’s lack of agency is the connective tissue creating a cohesive whole from three different storylines. The first is a wife’s imprisonment and slow poisoning by her husband; the second, young girls’ forcible entry into the sex trade; and the third, women’s confinement in a private madhouse. The connecting through-lines are coverture and gender norms. Coverture was the English common law concept that merged dependent women’s legal existence with their husbands or guardians, removing their ability to have a legal voice. Gender norms of the period dictated that even wealthy white women were supposed to be submissive, polite, and defenseless. In this way, Augusta is also captive. Although no one is out to physically harm her or lock her in an institution, her younger brother’s inheritance of their father’s estate and his exertion of familial power as her legal guardian leave Augusta chafing against the boundaries of acceptable action. Augusta’s heroic actions to free those held against their will break her out of her gender restraints for brief, chaotic, and dangerous periods of time. She thrives in situations where she can “be defiant, occasionally ill-mannered, and completely indomitable.”^[1]

On the recommendation of Karen MacPherson’s column in the Washington Post, “The 10 Best Mystery Novels of 2023,” I read the novel for the first time early in 2024, enjoying the possible but highly improbable scenarios and the lively prose.^[2] In the novel’s first case, “Till Death Do Us Part,” Augusta, Julia, their carriage driver John Driver, and their butler William Weatherly are determined to save Caroline, who is locked up and being slowly poisoned by large doses of laudanum by her husband, Sir Reginald Thorne, for her inability to conceive a child. On the rescuers’ way to the Thorne’s estate, their carriage is beset by highway robbers, one of whom is Lord Evan, convicted of murder twenty years earlier and sent to the New South Wales penal colony (as readers, we believe in his innocence). He recently absconded from the colony and made his way back to Britain where he has been supporting himself through theft. The spark between Lady Augusta and Lord Evan is almost immediate and their desire to protect one another brings each of them into the other’s orbit throughout the novel. Each time, they pledge to break their ties, and each time, they are brought back together by circumstances and longing.

By the end of the second case, Augusta promises her sister that she will stay away from Evan for both of their sakes. Instead, when Evan writes to Augusta begging her to help rescue his sister, Lady Hester, Augusta agrees. And even her decision is supported by Julia who realizes (better late than never) that she and their brother tried to “force” Augusta into their “idea of what a woman of our age should be: the gendered norm of hardly seen and definitely not heard.”^[3] After asking for Augusta’s forgiveness, Julia sends Augusta on her way, promising to join the rescue as soon as she is able. Hester needs rescuing as she has been confined for two years at Bothwell House, a private madhouse exclusively for women. Lord Deele, Evan and Hester’s brother, was disgusted by Hester’s sapphic attachment to Miss Elizabeth Grant and committed her there. As her guardian, he had the right to confine her against her will. Although it is impossible to tell how widespread this practice was, it was common enough that the author Daniel Defoe had protested against the practice in the early 18th century, writing that men sent “their Wives to mad-Houses at every Whim or Dislike.”^[4] In Goodman’s novel, it is a brother rather than a husband who confines Hester. But she suffers like the real historical women Defoe defended.

Disguised as Mr. and Mrs. Allen, Augusta and Evan enter the employ of Bothwell House, finding horror after horror as they devise a plan to rescue Hester. The Bothwell they find is fictional, but in writing Bothwell, Goodman relied on the accounts of two public hospitals, the York Asylum and Bedlam Hospital, which were described by popular nonfiction author Paul Chamber in Bedlam: London’s Hospital for the Mad.^[5] Using Chamber as a guide, Goodman succeeded in revealing the historical realities of the worst abuses of those systems using fictional characters. This included recreating the very real horrors that local inspector Godfrey Higgins (1773-1833) found at the York Asylum in 1814. According to historian Anne Digby, Higgins discovered four hidden cells there that were “only eight feet square, and inches deep in excremental filth.” In these filthy conditions, “thirteen old women had spent the night.”^[6]

In Goodman’s novel, thirteen women are housed in a stable instead of hidden cells, but the conditions are no better than those of actual asylums. The women remain inches deep in excrement as they are kept chained and imprisoned at all times. Lady Hester is not among these women and is situated in a separate room within the madhouse, but is also shackled to a bed. She is reduced to a fugue state by the time Augusta finds her. All the women housed at Bothwell are constrained, and some of them face sexual abuse from Keeper Horace Judd or the men employed there. Unlike Bedlam, the historical hospital, however, there are no spectators, no one paying for the chance to gawk at the women imprisoned there. In this novel, Bothwell remains isolated and dangerous until Augusta and Evan’s actions shine a light in a dark corner of the world.

In creating the fictional madhouse, Goodman brought together all the worst abuses that took place in the 19th-century English asylums under one roof, bringing her readers into a world of horror. While not always concentrated to the same degree, and not enacted in all real-life institutions, these horrors were real for some institutionalized women and men. In her fictional world, Goodman dedicated a considerable portion to documenting the filth, the stench, the bruising, and the shackles. She is not a historian, but she brought historical realities onto the page. With this novel, readers are given the opportunity to learn an important part of history. Even those unfamiliar with the world of 19th-century asylums may pick up the novel simply because of the very clever title or a positive review, but then find themselves musing on the intersections of gender and medicine, coverture and asylums.^[7] Maybe the reader will then look up Quaker asylum reformer, Samuel Tuke, who plays a role in the third case, and walk away knowing a little bit more about the history of mental health care and efforts at reform.^[8] Drawn in by the madcap adventures (and unconsummated romance), they will stay for histories of gender and medicine.

This historian came for a light read but left impressed with the serious content Goodman wove into her fun and fantastical fiction. Many of us rely on the historical imagination in telling factual stories and while we may dream up fictional characters, we leave them out of our works. Goodman has the power and freedom to create characters and actions that inhabit the real-life worlds of the past that historians document. In doing so, she brings a history some of us have immersed ourselves in to new audiences.

Notes

1. Alison Goodman, The Benevolent Society of Ill-Mannered Ladies (Berkley Prime Crime, 2023), 136. ↑
2. Karen MacPherson, “The 10 Best Mystery Novels of 2023,” Washington Post, November 14, 2023, https://www.washingtonpost.com/books/2023/11/14/best-mystery-novels-osman/. The novel was also longlisted for Historical Novel Award with the Historical Novel Society Australia and was on the Amazon Editor’s Best Books of 2023 list. ↑
3. Goodman, The Benevolent Society of Ill-Mannered Ladies, 330. ↑
4. Quoted in Leonard Smith, “The Keeper Must Himself be Kept’: Visitation and the Lunatic Asylum in England, 1750-1850,” Clio Medica 86 (2009): 201. ↑
5. Paul Chamber, Bedlam: London’s Hospital for the Mad (The History Press, 2019). ↑
6. Anne Digby, “Changes in the Asylum: The Case of York, 1777-1815,” Economic History Review, 36(2), 225. ↑
7. A good overview of the field can be found in Amy Milne-Smith’s “Gender and Madness in Nineteenth-century Britain,” History Compass 20, no. 11 (2022), doi:10.1111/hic3.12754. ↑
8. One of the classic works that examines mental health reform history is Roy Porter, Mind-forg’d Manacles: A History of Madness in England from the Restoration to the Regency (Harvard University Press, 1987). ↑