Attending Madness: At Work in the Australian Colonial Asylum by Lee-Ann Monk

Abstract

Health & History ● 12/1 ● 2010 133 view than from the patient’s. We have all learned to value looking at psychiatric disturbances from the point of view of the sufferer, but the extraordinarily fragmentary character of the surviving evidence makes it very difficult to move beyond generalities and speculation to any very detailed or substantial discussion of matters of this sort. One group of patients does stand out: aboriginal and Maori patients, for whom admission to an asylum tended to be a one-way process, ending with their death in the asylum. Coleborne has produced a pioneering book that opens many issues up for further discussion. I think she would be the first to admit that this is very much a first foray into a complex and difficult terrain, and her work in many ways raises more questions than it can answer in any definitive fashion. She is rightly aware of the many ways in which insanity could prove a calamity for both the individual and for his or her family. And she is clear-eyed about the limits to our knowledge that result from the way archives have been constructed, and accordingly, what evidence remains from which we can reconstruct our historical accounts. Those are not small virtues, and her book constitutes a valuable addition to on-going debates. ANDREW SCULL UNIVERSITY OF CALIFORNIA, SAN DIEGO Lee-Ann Monk, Attending Madness: At Work in the Australian Colonial Asylum, Clio Medica 84, Wellcome Series in the History of Medicine (Amsterdam/New York: Rodopi, 2008). ISBN 978-90-420 -2419-9 (HC). 4 B&W illustrations, 270 pp. This study, which focuses on asylum workers in asylums in colonial Victoria, has much to recommend it. Monk’s initial point—and it is a significant one—is that historians of asylum workers need to move away from considering attendants as proto-nurses. Instead, she identifies the role of ‘attendant’ as a valid form of employment in its own right, removing it from the ‘pre-nursing’ position which it has unfortunately occupied for too long. The role of attendant provides a different lens through which to view the colonial lunatic patient: attendants were closer to the patients on a daily basis, and their impressions of and attitudes to madness are painfully apparent. Attending Madness is full of useful information 134 BOOK REVIEWS about the development of the Yarra Bend Asylum, the Kew Asylum and their subsequent government inquiries. Monk’s attendants are vivid characters; they have a strongly three-dimensional sense, which is helped by her use of original sources which speak for themselves. Monk provides a thorough analysis of the role of the attendant: what qualities were and were not desirable; whether this translated into actual practice; the place of violence and cruelty in the asylum, and official responses to this. The gendered implications of asylum work are immediately obvious: the patient population was largely male and from the labouring classes, but the men who cared for them were drawn almost entirely from the same class, and largely uneducated. Once this is understood, the institutional importance of drawing a very sharp line between patient and attendant is clear. Monk’s book helps us to understand how these issues of gender and class translated into the day-to-day practice of working in Yarra Bend and Kew, including the perceived male role as breadwinner which dominated the debate over wages for asylum workers. Importantly, Monk also examines the beginnings of formalised training for asylum attendants. The debate between the ideas of ‘general’training and ‘mental’training in nursing, as well as between ‘training’and ‘experience’, are perennial ones, and dominated nursing education in Australia for decades. The idea of ‘on the job training’as preferable (and indeed desirable) is one of the cultural aspects which marks out the nineteenth century so clearly from the twenty-first, but the furore over the transfer of nursing training to universities is a more recent reminder. Given the fascinating subject material, the book’s style is a little disappointing. There is a tendency to reproduce a marvelous quote, but then to undo its impact by spending the next paragraph repeating the contents of the quote, and telling the reader...