Moral Treatment takes place in 1889-90, at a psychiatric hospital in rural northern Michigan. It shifts between the perspectives of the hospital’s aging medical superintendent, referred to throughout as “the doctor,” and a seventeen-year-old patient, Amy Underwood, diagnosed with “pubescent insanity.” Across the course of a year, both characters grapple with questions of identity in a setting that’s pushing them to change.
I’m not able to write in earshot of any kind of intriguing sounds, whether music or strangers’ conversations in a coffee shop. If my musical tastes influence my writing, it’s at a subconscious level. But as I developed my novel’s teenaged protagonist, I did think about how music would figure in her life. Amy’s favorite songs are referenced several times in the novel and are included below. To round out the list, I’ve selected songs that reflect the personalities and interests of some of Moral Treatment’s other key characters.
This late-nineteenth-century playlist pairs best with a restorative swig of wine of coca (ask your druggist!) or a healthful cup of beef tea.
“Clementine,” Percy Montrose, 1884
Amy is a teenager in an era before the commercial advent of the phonograph, let alone the Walkman or iPod; thinking about her relationship with music, I knew it would necessarily be different from the private, obsessive listening I did at seventeen. Instead, I used music to define her best memories with her father. Alone in her room at the hospital, she remembers him playing the piano and singing to her—long, narrative songs like “Clementine” and “The Daring Young Man on the Flying Trapeze.” I chose these songs because of their endurance—I’d sung them in my own childhood—and because, despite their humor, they’re both quite melancholy.
You might recall that Clementine, the miner’s large-footed daughter, drowns after tripping over her makeshift, sardine-can sandals. I’d forgotten that her lover, the song’s singer, is “dreadful sorry” that he failed to save her, but nonetheless swiftly moves on to kiss her little sister. The song’s off-handedness about Clementine’s death is unsettling, and I felt it apt that Amy’s emotionally-distant, oblivious dad would sing it to her. (Making it more inappropriate: his second wife is the first-cousin of Amy’s deceased mother).
“The Daring Young Man on the Flying Trapeze,” George Leybourne & Gaston Lyle, 1867
The gender dynamics of “Clementine” contrast with those of “The Daring Young Man on the Flying Trapeze.” In “The Daring Young Man,” the singer’s beloved prefers the man on the flying trapeze to him, her conventional, parent-approved beau. The singer drops in for a visit one night only to discover that his girlfriend has eloped with the circus performer: “from two stories high, he had lowered her down / to the ground on his flying Trapeze!” Months later, the singer is scandalized to find his ex performing in the trapeze act, having even “assume[d] a masculine name.”
I love the transgressiveness of this “maid in her teens”—breaking out of her conventional role and doing something so exhilarating and strange. Paired, these two songs convey a sense of Amy’s imaginative landscape. She’s witnessed the dangers of adult womanhood; she can feel those dangers encroaching—and though her efforts to escape have backfired thus far, possibilities still beckon.
“Little Annie Rooney,” Michael Nolan, 1889
In the nineteenth century, new songs circulated as sheet music or through live performances. I knew from my research that music was important to institutions like my fictional hospital, as part of evening entertainment programs, church services, and daily life on the wards, which were outfitted with organs or pianos. Thus when Amy’s wardmates play and sing for her on her 18th birthday, they play “Little Annie Rooney,” one of the top-selling sheet-music songs of 1889.
“Little Annie Rooney” is a sentimental tune, sung in the voice of Annie’s fiancé, who paints her as the epitome of sweetness, style and taste. But Little Annie Rooney was reinvented in the early twentieth century as a hard-luck orphan living on the streets, played by Mary Pickford in a 1925 silent film and going head-to-head against Little Orphan Annie as a newspaper comic strip from 1927-1966. The Annie of Nolan’s song seems utterly domestic and doll-like; the Annie that persisted in pop-culture was a scrapper. (“Having an Annie Rooney” even became slang for a fit of rage). The shifting image of Annie evokes the struggles that Amy and her closest friend, Letitia Olsen, experience in the hospital and out: they’re praised when they conform to a feminine ideal of meekness and docility, but to survive, they must rely on their own wits.
“The Nightmare Song,” Gilbert and Sullivan, 1882
The doctor’s musical tastes don’t come up in the novel; his new and growing hospital demands his 24-7 attention. The “moral treatment” he’s practiced for his entire career extends compassionate, holistic care to people experiencing mental illnesses—but yields very few “cures.” The doctor must constantly defend his methods to the hospital’s trustees, while also contending with the inevitable degradation of the overcrowded facility, and the difficulty of overseeing an increasing number of patients, attendants of varying reliability, and younger doctors eager to try experimental techniques.
Though the doctor doesn’t seek out music, his wife, Diana, prides herself on keeping up with current trends in arts and culture—which would certainly include attending performances of Gilbert and Sullivan’s popular operas. I imagine the doctor in a concert hall, half-listening, when he hears the frenetic lyrics of “The Nightmare Song” from Iolanthe:
When you’re lying awake with a dismal headache, and repose is taboo’d by anxiety,
I conceive you may use any language you choose to indulge in, without impropriety;
For your brain is on fire and the bedclothes conspire of your usual slumber to plunder you…
The song’s singer, the Lord Chancellor, is the opera’s chief antagonist—a figure of authority but also of ridicule, whose sleeplessness during “The Nightmare Song” is caused by his having fallen in love with one of the young wards of the Court of Chancery. While my doctor is not a sexual predator, he is the superintendent of the care and well-being of hundreds of vulnerable women and men. The song could be describing his own insomnia; it’s not a song he likes.
“Father’s a Drunkard and Mother is Dead,” Mrs. E.A. Parkhurst, 1866
One of my favorite minor characters in the novel is Bertha Chapman of the Women’s Christian Temperance Union, who visits the women’s wards and advocates for the patients’ rights. The WCTU championed many progressive social causes alongside their primary objective of outlawing the sale of alcohol. Mocked and maligned, they argued that alcohol abuse—rampant in this era—disproportionately impacted women and children. Bertha Chapman is outspoken and steadfast, a lifeline for Amy.
The Temperance movement wasn’t afraid to be over-the-top, and in seeking a song for Bertha, I appreciated the utter lack of subtlety (and, TBH, the catchiness!) of “Father’s a Drunkard and Mother is Dead,” as sung by the composer’s daughter, Little Effie Parkhurst, at the Great Temperance Gatherings in New-York:
Oh! if the “Temp’rance men” only could find
Poor, wretched Father, and talk very kind
If they could stop him from drinking why, then
I should be so very happy again!
Is it too late? “men of Temp’rance,” please try,
Or poor little Bessie may soon starve and die.
(Bonus track: “Bertha” by the Grateful Dead)
“Go Forward, Christian Soldier,” Laurence Tuttiett, 1861
Hymns are part of church services at the hospital—and this one is dedicated to Mrs. Lovelace, the first fellow-patient to take an interest in Amy. The wife of a minister, Mrs. Lovelace has been institutionalized for challenging her husband’s religious authority through her very public practice of extreme fasting. She boasts of being called “the Walking Skeleton of Charlevoix;” she claims to sustain herself on faith alone. Mrs. Lovelace also calls into question the doctor’s credibility, seeing the hospital, like her husband’s church, as a space of indoctrination and oppression. She stirs Amy with language of revolt and revolution—and confuses her, too.
From a host of strident hymns, I chose for Mrs. Lovelace “Go Forward, Christian Soldier,” which includes these evocative lines:
His love foretells thy trials;
He knows thine hourly need;
He can with bread of heaven
Thy fainting spirit feed.
Piano Sonata No. 14 (Moonlight Sonata), Beethoven, 1802
Finally, for Diana (the doctor’s wife), Beethoven’s Moonlight Sonata. A musicologist friend tells me that European composers of the late nineteenth-century weren’t yet known in 1889 in the United States, not even to culture vultures like Diana—but Beethoven was popular, so much so that the Moonlight Sonata might even have been “overplayed” by late-century.
Still, the Moonlight Sonata’s changing moods—from somber and mysterious to conventional and bright to stormy and dark—speak to Diana’s dynamic emotional range. Whereas the doctor is reserved, much more comfortable with shop-talk than small-talk, Diana extends herself toward everyone in the hospital community, ultimately becoming a good friend to Amy. Perceived as “delicate,” Diana is in truth shrewd, strong, and perceptive, capturing scenes of hospital life with her box-camera. Building in forcefulness over the course of the novel, I could imagine Diana snapping piano strings by the end, as the Moonlight Sonata did, at its premiere.