One can imagine the flurry of preparations Dr. Richard J. Patterson, his wife, and their staff of nurses undertook in late May of 1875 when they received news that they were about to admit their most important patient to date.
The doctor had dedicated the last decade of his life to building a sanitarium that embodied his progressive mental health philosophy.
Decades before Nellie Bly’s infamous 1887 exposé Ten Days in a Mad-House would shine a light on the horrors occurring at one New York insane asylum, Patterson was developing a treatment plan based on “rest, diet, baths, fresh air, occupation, diversion, change of scene, no more medicine than… absolutely necessary, and the least restraint possible” for his patients struggling with mental health maladies.
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His compassionate approach was only offered to “a select class of lady patients of quiet unexceptionable habits.” But even within the high-class clientele treated at Bellevue Place, the former school-turned-asylum that had opened its doors in 1867, none of the patients had reached the caliber of the woman who was about to be forcibly checked in.
Mary Todd Lincoln, the former first lady of the United States of America, the widow of the assassinated president who had forever changed the country, had just been declared insane in a Chicago court of law following a case brought by her son Robert. She was to be moved to Bellevue without delay.
What was surely a monumental day for Patterson—the chance to provide treatment and relief to such an important woman who had faced almost unimaginable tragedy in her life—would sour months later when Mary would lead a campaign to free herself from the gentle confines of his care. With her release came the end of the final eventful episodes in the life of one of the most fascinating first ladies in history.
“It’s hard to criticize her delusions when so many of her fears came true”
For over a century, historians and medical professionals have debated the exact nature of Mary’s troubles. While theories have included everything from migraines and epileptic disorder to paranoid psychosis and spinal-chord disease, most agree that her problems were more severe than that most scandalous of 19th-century conditions: being a difficult woman.
Evidence of Mary’s erratic behavior can be traced back to her youth, and Jason Emerson, a journalist and Lincoln historian who wrote The Madness of Mary Lincoln, told The Daily Beast he found a history of mental illness in 14 members of the Todd family.
As Mary grew older and married a man who became increasingly famous, tales of her bad behavior began to swirl. While some of the rumors can be chalked up to malicious gossip—Mary was a polarizing figure with more than her share of detractors—others were based on true episodes.
Fanning the flames of her struggles with both reputation and mental health was the impossible position Mary found herself in as first lady during the Civil War. Admittedly, she didn’t handle her new position with as much grace as she could have. Emerson says that “for the first few years, particularly, she thought she was a queen. She thought she was better than everybody. And she treated everybody that way.”
But even when her delusions of monarchical grandeur had passed, Mary had a hard time finding acceptance from any quarter.
“When she was in Washington, everybody hated her. She couldn't win,” Emerson says. Northerners condemned her as a rebel because she was from Kentucky, while “everyone in the South thought she was a traitor, and everyone in the East thought she was this Western hick rube, and everyone in D.C. just thought, ‘well, you're not one of us.’”
Whatever her existing mental health condition—Emerson believes the problem was bipolar disorder—Mary’s life was filled with a degree of tragedy that undoubtedly heightened her troubles.
The most heartbreaking of the misfortunes she faced were those she experienced firsthand. Her husband was assassinated while she sat in the theater seat next to him, and she lost three of her four sons before adulthood to disease.
There is no doubt that Mary was paranoid. But it’s hard to criticize her delusions when so many of her fears came true.
She was constantly worried that her husband would be killed while in office. Following Lincoln’s assassination, she and Tad lived in Europe for several years. She feared their return journey across the ocean would prove fatal to Tad’s weak constitution.
Two months after they docked in New York City, Tad died of what was probably pneumonia. (Her son Eddie died at 3 of what was probably tuberculosis, and another son, Willie, succumbed to typhoid fever at 11 while living in the White House.)
Mary also had an almost debilitating fear of fire, one that seemed to have grown roots in her psyche after she survived the Great Chicago Fire of 1871.
“Mary’s symptoms are fairly well known today: hallucinations, delusions, periods of depression followed by periods of great elation, narcissism, monomania, and insomnia, to name just a few,” Emerson wrote in 2008. “Specifically, she said she heard and talked to voices in the walls and in the floors, she believed buildings and entire cities to be on fire or in danger of fire, she saw danger in inanimate objects, and she had a compulsive need to spend money and acquire possessions.”
The events that would lead to Bellevue were set in motion in March 1875 when Mary became convinced that Robert, who by this time was her last living son, was critically ill. She set out by train from Florida to Chicago, where she found him the picture of health.
Mary, on the other hand, had her own troubles to report. “On her arrival, she told her son that someone had tried to poison her on the train and that a ‘wandering Jew’ had taken her pocketbook but would return it later,” Emerson writes.
She settled down in the Grand Pacific Hotel and Robert began his vigil. This wasn’t the first time that a family member had expressed concern about Mary’s safety due to her mental illness. Robert had wondered years before if he might have to have his mother committed, as did Abraham Lincoln during their days in the White House.
But the behavior observed by Robert—and the Pinkerton detectives he hired to watch Mary—sealed her fate. Following the proper procedures of the day, Robert launched court proceedings to have his mother ruled insane and remanded into the care of Bellevue Place.
From the perspective of our current day, Mary’s insanity trial appears to be a farce of justice. She was blindsided by her son’s betrayal, immediately found herself in court where the prosecution put forward a parade of witnesses to tattle about her misbehavior while her own lawyer, who was paid by the son who launched the offensive, didn’t call any witnesses to the stand. The whole affair took place in a single day, and less than 24 hours later, she was whisked off to the asylum.
But Emerson points out that, by the standards of the day, Mary received preferential treatment.
“Under the law, Robert should have had his mother arrested, put in handcuffs, and dragged off to the courtroom,” Emerson says. Instead, Leonard Swett, the family lawyer who was handling the prosecution, convinced Mary to come to court willingly.
A new law required that there be at least one physician in the jury in order to convict a woman of insanity. Mary’s jury not only had medical representation, it was made up of “12 of the most respected men in the entire city of Chicago, including a congressman. And the judge did that on purpose, because you're not just going to get a couple of corset makers or hat makers or something to try Mary Lincoln.”
By all accounts, Mary settled into her sanitarium life well. At first, she gladly received Robert when he visited each week. She was allowed to take the horse and carriage whenever she wanted, and the doors to her private suite were only locked at night. She was even allowed to receive journalists. After one of these visits, a reporter from the Chicago Post and Mail concluded in print, “no encouragement is held out that Mrs. Lincoln will ever become permanently well.”
In short, no one seemed surprised that Mary had ended up in an insane asylum—after all she had experienced, it was a miracle she hadn’t been committed sooner!—and no one questioned Robert’s decision to put her there.
Until Mary decided to take matters into her own hands. No one really knows what caused her change of heart, but one day she launched a covert operation to gain her freedom.
On that day, she left the sanitarium under the auspices of mailing a letter to her sister. When she and her companion arrived at the post office, she insisted on completing the errand herself, and then she proceeded to secretly mail a slew of letters to various important people begging them to help her gain her release. One of the letters went to her prominent Chicago friends, the Bradwells, who took it upon themselves to lead the outside charge to free Mary Lincoln.
A frenzy ensued with accusations, many false, being lobbed back and forth, usually in the pages of the newspaper, between the Bradwells, sympathetic journalists recruited to the cause, and Mary on one side, and Robert and Dr. Patterson on the other.
By the end of it, Patterson was beside himself. Here he was, a good doctor, just trying to provide comforting and wholesome care to his well-to-do charges, and his name and reputation were being muddied on behalf of his most prominent patient. He became so frustrated that he finally took to the papers to defend himself, his establishment, and his treatment of Mary.
“It is no fault of mine that the sad case of Mrs. Lincoln has been again in all the papers of the land,” Patterson wrote in a letter published in the Chicago Tribune on August 29, 1875. He then went about setting the record straight. “She is certainly much improved, both mentally and physically; but I have not at any time regarded her as a person of sound mind.”
Mary may not have been of entirely sound mind, but she was smart and sane enough to prevail. She was released from Bellevue Place on Sept. 10, 1875, and a new trial overturned her insanity conviction. Mary left for Europe, and refused to speak to her son Robert for five years.
As one century became another and the decades passed, scholars began to question Robert’s motives. He was, after all, named the conservator of his mother’s estate during the time she was confined to the asylum, and her excessive spending habits were well known. But evidence points to his motives being purer than a brazen attempt to get his hands on his mother’s money.
Robert was genuinely concerned about his mother’s well-being. But in the end, he determined his legal actions against her weren’t worth the damage to their relationship.
“She said many times [that] she left for Europe so that Robert wouldn't commit her,” Emerson says. While she was abroad, Robert wrote a letter to his aunt, who was trying to get them to reconcile. “And he said, I'd forgive her in a minute and not think anything of it, but she won't speak to me. And he said, if I knew then what I know now, nothing in the world could have enticed me to have her committed again. And if she came back, there's no way on Earth, I would try and do that to her again.”
