Book review: A Madness So Discreet, Mindy McGinnis

Due out in October, A Madness So Discreet takes the reader into the heart of 19th century asylums, and into the earliest iterations of the radical reforms seen in the criminal justice system over the same period. As pseudoscience abounded, so did an actual critical evaluation of criminal behaviour, what makes people break the law and why, and how to handle investigations more seriously. The book tells the story through the narrative of Grace Mae, a young woman sent to an asylum for reasons I’ll discuss in a moment, and a young doctor who’s interested in changing the way people talk about madness — and investigate crimes.

First, the good. This text is a radical departure for McGinnis, who took us into proto and post-apocalyptic water wars with her previous two books. Not A Drop to Drink was a fantastic book, but it had a very different style and tone, as was appropriate, considering the very different subject matter. The exploration of a different writing voice is a testimony to flexibility and talent, illustrating that McGinnis is not a one-note author incapable of pushing herself to look at different narratives, different periods, and different settings. She has a strong writing voice, but it doesn’t overwhelm her actual writing and the stories she needs to tell.

Speaking of which, she tells the very genuine, real, and terrifying stories of turn of the century mental institutions. Grace is shunted into a mental health facility because she’s ‘of good family’ and she’s pregnant, so her family has resolved the issue by hiding her until the baby is born, a once common tactic intended to hide the shame of awkward pregnancies. Many other women are institutionalised for causes like being inconvenient to their families or husbands in some way or another, all real things that happened — as one of her fellow inmates remarks, all it takes is a judge and a stroke of a man’s pen. This was a really awful period in history for rebellious women, or even women who simply weren’t afraid to speak their minds and defend themselves, and that’s really explored in harsh, unflinching detail here.

The setting of the asylum is also painfully accurate. This isn’t the rosy, beds in light, airy rooms, patients drifting happily around the grounds image of mental health facilities that many contemporaries drew up. The asylum is dark, dreadful, and horrifying, with barbaric ‘treatments’ used to suppress and torment patients. Those who are particularly bad go to ‘the cellar,’ where Grace finds herself after crossing the line with the director of the institution. The particularly intractable are subjected to a crude form of lobotomy, in a disturbing procedure we see in glimpses and references — though it should be noted that the doctor who performs the procedure comments on it as a form of ‘mercy,’ treating his patients. I highly doubt that McGinnis shares the belief that mentally ill people should be referred to in ways that ring uncomfortably similar to the way we talk about euthanasia, but it is something to note about his characterisation — he sees the mental health system as so bleak and inescapable that this, for him, is the only way out for some patients.

Grace escapes the institution via somewhat complicated means, pairing up with the doctor as he explores new ways to investigate crime. He believes that the justice system is deeply broken and most police don’t take crimes like murder seriously, so he’s begun evaluating murder scenes more critically, with a sharp eye to detail and the application of science to a largely haphazard affair. He brings Grace along as silent observer, noting that people often feel freer to talk around women and those they think won’t be heard or taken seriously if they speak up. In this sense, she acts as the fly on the wall, a commentary on the way women of the era were treated — and on the way women continue to be treated today, as so inconsequential that they fade into the background like wallpaper.

At the same time, she’s living under the guise of his patient at one of the ‘model institutions’ of the era, a facility designed to showcase what mental health treatment could and should be. The kinder, gentler approach to incarceration of mentally ill people in this setting was especially dramatic when compared with that seen at her former institution, but at times it came across as highly patronising, which was rather disappointing.

Perhaps the most unfortunate part of the book, though, was the presentation of asylum as punishment at the end of the text, a subject that’s difficult to delve into without spoiling part of the plot, so you should stop reading here if you haven’t read the book yet and would prefer to let the story unfold on its own terms.

The grand secret of Grace’s pregnancy is revealed when we learn that she got pregnant because her father was molesting her — she was hidden away in an asylum not just because her state would bring shame on the family, but because he wanted to conceal his role in it. She, understandably, struggles with the aftermath of the incest, a subject that isn’t often covered in YA fiction, so I was pleased to see it included and handled very well here.

However, her ultimate revenge involves placing him into the very asylum she escaped. This is presented as a sort of poetic justice, forcing him back into the horrific conditions she was forced to endure as a result of his cruelty, but in the process it reiterates the theme that often crops up in pop culture where asylums and their role in society aren’t critically interrogated. Surely he could have been punished in a more intriguing and innovative way.

Overall, there’s a lot to like about this book, but be prepared to interrogate some of the plotting decisions to do it justice.