Davis, Gayle

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     Edinburgh Research Explorer                                      Attending Madness: At Work in the Australian Colonial AsylumCitation for published version:Davis, G 2010, 'Attending Madness: At Work in the Australian Colonial Asylum' Bulletin of the History ofMedicine, vol 84, no. 1, pp. 137-139.Link:Link to publication record in Edinburgh Research ExplorerDocument Version:Publisher's PDF, also known as Version of recordPublished In:Bulletin of the History of MedicinePublisher Rights Statement:Copyright © 2010 Johns Hopkins University Press. This article first appeared in Bulletin of the History ofMedicine, 84(1), 137-139. Reprinted with permission by Johns Hopkins University Press.General rightsCopyright for the publications made accessible via the Edinburgh Research Explorer is retained by the author(s)and / or other copyright owners and it is a condition of accessing these publications that users recognise andabide by the legal requirements associated with these rights.Take down policyThe University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorercontent complies with UK legislation. If you believe that the public display of this file breaches copyright pleasecontact openaccess@ed.ac.uk providing details, and we will remove access to the work immediately andinvestigate your claim.Download date: 28. Apr. 2017book reviews Bull. Hist. Med., 2010, 84 137        Lee-Ann Monk. Attending Madness: At Work in the Australian Colonial Asylum. The Wellcome Series in the History of Medicine. Amsterdam: Rodopi, 2008. 266 pp. €55.00 (978-90-420-2419-9).The history of psychiatry remains an excitingly productive and argumentative field of research, though not one for the claustrophobic. A disproportionate amount of this research, which stems in one way or another from the seminal work of Michel Foucault and Andrew Scull, has focused on the dramatic rise of the asylum as a response to insanity during the nineteenth century and the consequently emerging psychiatric profession that assumed control of inmates. This historiographic preoccupation with the lunatic asylum has produced many interesting and nuanced studies of individual institutions and their doctors, and of the wider relations among patient, doctor, and state. However, one particular group of asylum staff, with only a few notable exceptions, tends to be excluded: the attendants. This fact is regrettable given their numerical importance compared to the “medical” staff and the fact that patients were “for the greater part of the day under their exclusive care” (p. 149). Even a patient’s medical care depended to some extent on the attendant’s observation and daily management, as the atten-dant was often the one to acquire detailed knowledge of individual patients and to initiate a doctor’s examination, given the high ratio of patients to doctors. Thus, Lee-Ann Monk’s Attending Madness, a social and cultural survey of asylum attendants during the second half of the nineteenth century, is a welcome addition to the historiography. She argues rightly that attendants merit more sustained his-torical analysis than they have received to date, being conceptualized in the main as, at best, the rough-and-ready occupational predecessors of twentieth-century skilled psychiatric nurses (with the emphasis very much on “rough”). Rather, they 138 book reviews Bull. Hist. Med., 2010, 84deserve to be understood in their own right. Monk locates her work within the colonial context, focusing in particular on asylums within the British settler colony of Victoria, Australia. Given that the subfield of colonial psychiatry has grown par-ticularly rapidly in the last two decades, it is regrettable that the author has chosen in the main to engage with the historiography (or lack thereof) of asylum atten-dants and has not incorporated the rich colonial historiography to any significant extent. Nonetheless, Monk provides a detailed consideration of attendants—their characteristics, their everyday work, how they constructed their own occupational identity, and how others defined them—within the context of the establishment, institutional ideology, and operation of psychiatry in Victoria. Since asylum offi-cials drew to a considerable extent on British ideas about the nature of insanity and its treatment, and even poached personnel from “home,” there are also some useful comparative considerations of British psychiatry and how British ideas on the attendant ideal were articulated within the colonial context. The early-nineteenth-century “mad-doctor” W. A. F. Browne remarked that attendants were “often of the very worst caste,” attracted to that career path as a consequence of the low wage and dangerous duties (pp. 8–9), a verdict that many historians have seemed content to accept. However, Monk paints a more nuanced picture, in harmony with David Wright, of a “steady” occupation whose “decent” wages made it “an occupation keenly sought by many ordinary workers for its security and the prospects it offered to fulfil their aspirations” (p. 9). Thus, over time asylum attendants in Victoria remained in employment for longer periods, developing and articulating a specific occupational identity. Attendants were to “keep a watchful eye” over patients at all times and to investigate and report any-thing suspicious or potentially harmful. Restraint of any kind was to be avoided, and verbal or physical coercion was forbidden. The colonial asylum attendant was to be humane, self-restrained, and temperate. There were, however, impediments to the pursuit of this ideal. The Victorian gold rushes attracted the colony’s male population, including those already employed elsewhere as attendants, while the low wages, unpleasant nature of the work, and “unavoidable” risk of violence from patients—“[t]he equation between risk and recompense” (p. 126)—acted as repellents. It is little wonder, then, that we find periodic reports of less than “ideal” attendant conduct, with patient neglect and punishment at the hands of callous or intoxicated attendants. There were also divisions within their own ranks and, increasingly, resentment against the medical profession’s claim to sole expertise in asylum management.Perceptions of the “ideal” attendant were strongly masculine, and men atten-dants were better paid. Fewer women were employed as attendants, given the preponderance of male lunatics and the fact that attendants were to care only for patients of their own sex. Much of the attendant’s work was nonetheless domes-tic in nature and involved personal care of patients who required to be washed, dressed, and shaved. Asylum officials complained of “physically weak” women staff, and sought those “strong and mature” enough to “command obedience from patients” (pp. 161–62). Conversely, in the case of men attendants, officials argued that they required to be “young and malleable” (p. 110), in opposition book reviews Bull. Hist. Med., 2010, 84 139to men attendants themselves, who argued strongly that older men made better attendants. Attending Madness offers no explicit conclusions, even in its final chapter, leav-ing the reader in large part to draw together the main threads of analysis. However, Monk provides much useful empirical detail and analytical insight in sketching the history of a little-considered occupational group during a crucial period within this geographical context, when officials were attempting to transform the asylum from custodial jail to therapeutic hospital. Gayle DavisUniversity of Edinburgh                        

Attending Madness: At Work in the Australian Colonial Asylum

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