A Fortune of Sand

In the early 20th century, psychiatric understandings of women’s mental health were influenced by contemporary assumptions about gender. In the preceding decades, diagnoses such as “nervous exhaustion,” or neurasthenia, were associated with ideas about women’s supposed physical and nervous limitations. Neurologist S. Weir Mitchell, for example, argued that excessive education and intellectual exertion could damage women’s health and prescribed some female patients a restrictive “rest cure” involving isolation and enforced inactivity. Such medical thinking could reinforce wider social restrictions on women’s intellectual and creative lives. The history of involuntary commitment also includes cases in which husbands or relatives used institutionalization against women. One prominent example was Elizabeth Packard, who was committed to an Illinois asylum by her husband in 1860 after challenging his religious views; her subsequent campaign for reform helped strengthen legal protections for people facing commitment. By the novel’s 1927 setting, however, commitment in Michigan involved legal procedures: Relatives could initiate proceedings, but institutionalization was subject to probate-court and medical processes.

A Fortune of Sand directly explores these concerns. Ivy’s husband dismisses her creative expression as a “disorder” and calls her delusional and “insane”; Ivy states that her actual diagnosis is “mourning and melancholia” (219), and her husband later refuses to have her return home. Similarly, Duncan Lennox plots to institutionalize his own daughter, Marjorie, at Eloise, while her Nightingale file records an “Alleged Diagnosis” of “Chronic Imaginative Derangement” (197). The fictional Nightingale is designed partly to evaluate women whose families claim they have mental illnesses and, according to Juliette, protect them from unnecessary institutionalization. Juliette Bonafante’s own history of being confined to her room for three years by her father, who believed that her changing behavior meant she was “possessed by the devil” (200), provides a personal motive for her work. After an impacted tooth was discovered and removed, Juliette’s symptoms subsided; she tells Marjorie that she could have been institutionalized permanently. Sepetys notes that her historical research uncovered accounts of “misdiagnosis, revenge, and involuntary commitment” (302), providing a historical basis for this aspect of the novel.