Isla nerviosa: madness, psychiatry, and reform in nineteenth- and twentieth-century Cuba

Abstract

This history of Cuba's main psychiatric asylum, Mazorra-named after the owner of the slave plantation upon which the hospital was built-aims to be much more. Impressive in scope, historical detail, and thoughtful analysis, Madhouse largely meets its two parallel, if overlapping goals: to trace the history of attitudes towards and the experience of mental illness in Cuba, and to introduce a set of new historically-informed concepts for understanding Cuban mental states. Lambe evokes the latter in a line on the very first page of the book's Introduction: "In the borderlands of indifference and on the margins of meaning lies Mazorra, primordial laboratory of the fifth dimension" (Lambe, 2017, p.1) The book fulfills the first goal well and provides a lot of insight into the second. Lambe's goal is not just to reconstruct Cuba's attempts to deal with mental illness, but to understand the contours and effectiveness (or lack thereof) of the Cuban state through three or four very different eras. From the late nineteenth and early twentieth centuries, with its two US occupations, to the years of corruption, the Revolution, and beyond, Lambe documents the tremendous changes in the Cuban psych fields, as well as some continuities. The first sixty-plus years of Mazorra's existence were marred by brutal levels of neglect; the mid-twentieth century attempts at reform had minimal effect. After the revolution, the government harnessed the power of a strong, centralized state and clear sociological objectives to broaden and deepen the treatment of social pathologies. Throughout, Lambe argues, Mazorra remained an enduring symbol of the island, including its best and worst images. Madhouse is framed by a number of themes, including historical memory, medicine and the state, the cultural history of madness, and the history of sexuality. The book is organized chronologically, beginning the Introduction with the construction of the island's first insane asylum on the grounds of the former Mazorra plantation in the 1850s.