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

History: 331 pages

Published March 2013 by University of Iowa Press First edition. 

Reviewed by Janice P. Kehler

I began reading The Best Specimen of a Tyrant, while in New York attending a conference just as the news broke of the death of Jordan Neely, a homeless man suffering from mental illness. A marine veteran had taken Neely down and held him in a choke hold while both men travelled on a subway train. Television screens displayed choppy cell phone videos of the veteran’s stranglehold just as I was reading the word ‘choking’ in Doherty’s accounts of life in the insane asylum. Words and images from the twenty-first century invaded Tom Doherty’s historical accounting of the Wisconsin Insane Hospital; the winter of 1866 became embedded inside June of 2023.

Doherty expertly weaves the intersection of the personal stories of physicians, hospital attendants, patients, and their families with the manifestation of the Hospital Movement, an ideology that prescribed a culture of institutional ‘kindness’ as a cure for the mentally ill. The heart of the book follows the life of Dr. Abraham Van Norstrand as he cultivates a harsh brand of kindness. By the time he takes charge of the hospital, choking, along with other forms of corporal control, had his approval as a means to subdue the violence that erupted between caregivers and patients. Some patients died, some got better, everyone suffered. 

Norstrand’s adversary was Samuel Hastings, known as a ‘stickler for detail’. He had served as the Wisconsin state treasurer, had business ties to financial institutions and in the winter of 1866 had been appointed to the hospital board that oversaw the management of the publicly funded insane asylum. His strong belief in kindness as an unbreakable bond between word and deed formed the bedrock of his reputation as a social crusader. Seven years into Norstrand’s tenure, rumblings over the management of the hospital swirled around the board and the hospital prompting the formation of an investigative committee that included Hastings and two other trustees.

Van Norstrand’s incomplete memoirs, the annual reports of insane asylum and testimony of the hearings held in 1868, provide a “critical and searching examination” of the Hospital. The backdrop to the investigation was the inexplicable death of a well-connected religious man of the community whose brother was a colleague of Hastings. The cover-up by Norstrand of the gruesome death hovers over the reader from the first pages of the book until the last. 

Doherty documents the words and deeds of Norstrand and Hastings filling in the gaps by clearly indicating the context of his speculations. He directly quotes the words of Norstrand and others as headings for each chapter, a curious diction particular to that era that opens the door for each chapter to become a conversation with the past. In many places, Doherty offers a delightful turn of phrase—the upshot of events, the use of wind and hoof power, and the buck travelling downhill to the humblest player—all serve as islands of refuge for the reader against the grueling descriptions of absolute cruelty.  

Over one hundred years have passed since the investigation of the Wisconsin Insane Asylum. After reading the book, I found an article published in The Atlantic in 2023 revealing how insane asylums have been replaced by prisons and a justice system unable to find sustainable treatment solutions. But while in New York, I did see another side to this story, one that readers will also find in the book. Doherty describes a male attendant, Richard Palmer who committed himself to never striking a crazy man even when they struck him. He testified that on his ward there had never been punishments (referring to choking or knocking down patients). 

Those words resonated with me as I stood amongst a crowd of people at a crosswalk waiting for the light to change bathed in the smell of fried food from a nearby street vendor. Two black men approached the food wagon, one was well-dressed the other wore tattered dirty clothes. One striding the other stutter stepping aided by a makeshift cane that looked like a tree branch. They talked and pointed at the vendor and within minutes steaming oval-shaped packets of tin foil went from hand-to-hand unleashing smiles and nods that travelled from the vendor, the two men and then lastly to waiting pedestrians. 

Without doubt, Doherty’s history of the Wisconsin Insane Hospital, largely kept hidden from a public eye, will leave readers with a troubled but complicated view of ‘kindness’ towards the mentally ill. And as he notes in his introduction, the story of Dr. Van Norstrand will underscore all that could go wrong with the use of force approaches that became the default mode in the Wisconsin Hospital of the Insane. Bringing this story from the hidden pages of history into the ‘light of day’ is a reading experience that will be hard to forget. 

BIO: Reviewed by Janice P Kehler, MS MSc, ( https://jpkehler.com ) who has over 30 years of health care experience working in both Canada and the US. She is currently working on a book of personal essays weaving her story as an Olympic hopeful with the history of athleticism and exercise science.