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Abandoned to Their Fate: Social Policy and Practice Toward Severely Retarded People in America, 1820-1920 (Health, Society, and Policy)

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It's been called the Rise of the Common Man, the Gilded Age, a Progressive Era fueled by the Industrial Revolution. Every man could become a Carnegie, Rockefeller, or Vanderbilt. Well, not exactly.

If you were one of those for whom society had not yet even invented the term, "idiot", or "Imbecile", "Insane", or "Epileptic", you were likely to have been abandoned in a very real sense. Often, all it took was personal poverty. In the 1800s these people, whom society would label as "failures", were all classed collectively. The disabled and the poor were social pariahs, warehoused together philosophically and literally in the almshouse (poor house). The logic, though bitter (even cruel), is nonetheless consistent: the United States is a "perfect union" therefore those who do not fare well must be violating the great founding principles. If you are sick, or poor, you must be doing something wrong. In many circles, the logic persists to this day.

"Abandoned to Their Fate" examines a time when little was understood about intellectual or developmental disability. Record keeping was non-existent or inconsistent, offering broad diagnoses and imprecise behavioral descriptions to place -or condemn- one to an asylum. How did incarceration and cruelty come to characterize American institutions? Something had to be done when the almshouses became full or unmanageable!

Evolving "Abandoned to Their Fate" from his dissertation, Ferguson tells a story that combines context and sequence, interpretation and chronology. He notes that most individuals who were disabled did not live in asylums, but with their own family. He establishes chronicity as a professional judgment which defined, explained - and dismissed - the "failure": he who remained "untreatable" and may have been (without regret) abandoned. Ferguson examines, particularly, the records extant from the Rome [NY] Custodial Asylum for Unteachable Idiots. His research extends from the official records to personal and family correspondence. He is not unsympathetic to those serving the disabled during this period. He acknowledges the administrators who intuitively understood that some (if not all) those with an intellectual disability were "treatable", who bore the burden of obtaining necessary funding, and even their need to legitimize their profession, without the tools, or empirical validation, to do so.

"Abandoned to Their Fate" is relevant today as we face the fiscal ramifications of the Great Recession. In the 1850s, some people said that, "pauperism is a moral choice, even a physical disease, as much as an economic outcome". Many today offer the same arguments (and logic) to limit - or end - "entitlements". "Abandoned to Their Fate" compels us to search our hearts to consider our own values. Is employment - one's ability to make a widget, turn a cog, or extract a drop of blood for coin - all that matters in our value system? Is improvement relevant to a legislature (to a people) that values only economic utility? If we can't produce tent revival miracles, are supports and services really worth it? If responsibility is heaped on the individual, is he safe to scapegoat - and safe to neglect?

Of course, in truth, it is "We the People" who establish a more perfect union. Our government, our society, is ever evolving. Some would argue that suffering abandonment as a consequence is the "ultimate triumph of deterrence"; others would be anathema to the very premise.

Left unanswered is, "what to do"? Giving a damn is a good start.