Moral Treatment is your first novel, but you have other works out in the world and in progress. What would you say is the biggest difference between writing short fiction and a novel?

A: For me, what determines the eventual length of a piece is how much discovery I go through, in the writing. I tend to write my way into projects; I rarely know at the outset whether I’ve begun a short story or a novella or a novel. In fact, I’m currently working on a piece that I intended to be under 5000 words (for the not-very-high-minded reason that a lot of my stories are long, and I wanted to be able to submit to journals with lower word limits). And I thought I’d done it, written a 4500-word story—but at every stage of “completion,” readers have said the story needs to expand (and I’ve agreed). Now the piece is 9000+ words and not finished…it will either end up as an awkwardly-long story or keep growing into a novella.

I have a truly short story coming out soon that’s a triptych of Rumpelstiltskin retellings. I establish each tale’s settings and characters concisely, as recognizable variants on the Grimm Brothers’ versions, so the focus is on how this familiar, escalating plot arrives at somewhat unexpected morals. The three pieces are snappy and direct. Whereas the characters, situation, and setting of the awkwardly-long story are much more complex, and I haven’t yet gotten to the point where the story’s logic coheres on the page like it does in my head. Similarly, I was well into the drafting stages of Moral Treatment before I saw its arc, but once I did, I was able to outline toward that, plotting the events and choices that would lead to the novel’s climatic scenes and conclusion.

A lot of your writing is largely inspired by history. What periods or aspect of history interest you the most, and what keeps you coming back to the past as a foundation for your fiction?

I’ve written book-length pieces set in 1889-90 in Northern Michigan; 1850/1848/1837-38 in Boston and Providence; and 1842-43 in the Berkshires. I’ve lived in and have strong attachments to those places, but I knew nothing, beforehand, about any of those time-periods. What drew me to those specific moments was, in each case, an event/proximity to an event. And, while I didn’t want to be completely bound by facts, I did want the works’ settings to be highly textured and consequential to my characters’ lives, as the places and time periods that we live in are, to us. I began each of these projects knowing when and where it was taking place and, in a fundamental way, who my protagonists were; as I learned more about the social, material, and cultural conditions of those times and places, I imagined how those circumstances would shape my characters. For me, historical research always yields a set of productive constraints within which to develop characters and plot.

I love everyday details and materiality. The kinds of things my characters are reading, the music they’re listening to, the pop culture of their moment is important to me; I want my characters to exist in dynamic worlds. For that reason, I’ve turned to daily newspapers in researching all of my historically-situated fiction. Nineteenth-century newspapers fascinate me; their layouts are so dense and, to my eye, chaotic (the front page didn’t mean then what it means now). I’m interested in which items wound up next to each other in the layout, what issues were vying for people’s attention. I tend to think of history in a flat way, and looking at newspapers makes any given day multi-dimensional. It’s easy to miss that when your research is driven only by particular search-terms. For example, when researching one of my projects, I started out only looking at newspaper coverage of the shipwreck that killed Transcendentalist Margaret Fuller on July 19, 1850—and if I hadn’t begun reading more expansively, I would likely not have realized that President Taylor died just ten days earlier (after eating too much ice milk and cherries!)—an event would have been hugely significant to Americans. Moreover, bringing the sudden and ignoble death of the sitting president into my protagonist’s consciousness added another layer to the complete tumult that she’s experiencing during this summer.

The longest three things I’ve written are works of historical fiction, but they are far outnumbered by the short stories I’ve written, which are almost all set in the present (and a couple in the future). Most of my work is quite attentive to setting; crafting a setting just becomes a more involved undertaking when writing about a different time-period.

You’ve described avoiding writing about actual patient’s experiences due to it being appropriative. How did you balance the need to be factual and empathetic, without making a spectacle of or flattening the reality of the characters – in other words, honoring the characters and the lives they represent?

As a fiction-writer, my need to be factual is different than a historian’s, but I certainly did my best to respect and not sensationalize patients’ varied experiences. The two POVs of the novel show the difference between the doctor’s vision of the hospital and the patient’s lived experience; in using both of those perspectives, I tried to make all of the books’ characters dimensional, flawed, and sympathetic.

In developing Amy and the other characters being treated at the hospital, I drew upon the diagnostic categories used during this era; annual reports of multiple late-nineteenth-century hospitals; case studies in medical journals; and a few first-hand accounts, like activist Elizabeth Packard’s harrowing Modern Persecution, or Married Woman’s Liabilities (1873) or investigative journalist Nellie Bly’s (definitely sensational!) Ten Days in a Mad-House (1887). Most of these sources demonstrate how women who were institutionalized were understood by male doctors, and those incomplete visions prompted me to imagine fuller stories.

Looking at the “probable exciting causes” of “insanity” in historical records of the Northern Michigan Asylum is enough to provoke that narrative urge. These causes include heart-rending phrases like “domestic infelicity” or “grief, care and anxiety”—alongside physical causes, many related to women’s health, while others, like head injuries, or “insolation” (heat-stroke), suggest the daily hardships of a working life in rural Michigan. As I peopled the women’s wards of my fictional hospital, I emphasized the kinds of pathologized behaviors, beliefs, and identities that interested me the most; for example, like Elizabeth Packard, one of Amy’s wardmates holds fervent religious convictions that clash with her husband’s. The novel ventures only briefly to the men’s wards, but one scene does depict a case of advanced syphilitic insanity, an illness that accounted for at least 10% of all psychiatric hospital commitments in the nineteenth century, and by some estimates, substantially more. Overall, the fragility of our bodies was something that this research made me very conscious of—and really, that’s why Amy is at the hospital: because her parents are terrified that she will come to harm under their care.

One last point: patient records from Michigan’s state-run psychiatric hospitals are not available to researchers, which is as it should be to protect people’s privacy. But while I’ve been on book tour with Moral Treatment, people have shared with me their failed efforts to recover relatives’ records and even their own—a lot of that material seems to be lost or destroyed.

Between Amy’s pull to the trees and the natural world juxtaposed with her father’s lumber company and the central building of the novel being in constant need for repair, would you say that the eco-gothic was somewhat in play in writing Moral Treatment? If so, was it intentional from the beginning or did it evolve over time?

The term eco-gothic was coined in 2013, but I only became familiar with it in the last couple of years, after reading an article about eco-gothic strands in George Saunders’s Lincoln in the Bardo. That novel, like a lot of work described as eco-gothic, represents aspects of more-than-human nature as sentient and antagonistic to humans; in LitB, creeping tendrils ensnare souls who have tarried too long in the bardo, turning them into grotesque caricatures of their former selves.

Though I wasn’t thinking about eco-gothicism when writing Moral Treatment—and I don’t think the term actually applies to this book, for reasons I’ll elaborate upon in a moment—I was thinking about ecological grief, the psychic impact of witnessing deforestation. For Amy, trees are stand-ins for the human friends she left behind when her family moved farther north, “chasing the tree line.” Her father’s plan to harvest mature hardwoods from the steep slope in front of the family’s house indicates how extensively even this area has already been logged. As someone who grew up in the area where the novel takes place, it’s difficult for me to imagine the tree-lessness of the late nineteenth-century. But the hospital, too, which is inspired by the former Northern Michigan Asylum in my hometown of Traverse City, was built on a parcel of land that had already been cleared. Amy watches the doctor planting saplings on the hospital’s front lawn—again, a detail inspired by the historical hospital, whose founding superintendent planted an arboretum that still exists today. So we have this very curated plant environment replacing the biome that once was there. Amy definitely feels that loss; it contributes to her sense that the world offers very narrow possibilities.

All in all, I think to classify Moral Treatment as any kind of gothic work sets an expectation of hauntedness that won’t be fulfilled; there’s nothing supernatural in this novel. That said, for some readers, the later history of hospitals like this one might float like a specter over the brand-new hospital of the book.

The doctor in Moral Treatment is always well-meaning, but also overwhelmed and not always able to be open to or understand what would be best for his patients and hospital. We know it was important for you to keep him nuanced and flawed, but if you could go into the novel and give the doctor some advice, what would it be?

Listen to your wife! The doctor and his wife, Diana, met when Diana was a patient at a health resort, shortly before the doctor returned to asylum medicine; their doctor-and-patient dynamic is long-standing, even though they both know it’s no longer appropriate or constructive. Like the doctor, Diana is also nuanced and flawed—but she understands things about people, and about the hospital, that he can’t see.

What do you want people to know about your new project/s? What excites you the most in your latest writing?

My completed project, Many and Wide Separations: Two Novellas, will hopefully be out in the world before too long. The two works in that collection are both about women artists in mid-nineteenth-century New England, who are trying to find their voices in challenging situations. The title novella follows an imagined character who studied with Margaret Fuller when she was a teenager. In the present-time of the novella, she’s trying to make sense of Fuller’s tragic death and of her own somewhat catastrophic recent life choices. The other piece, A Passing Likeness, takes place largely in a Shaker village, during the Era of Manifestations—a period when Shaker sisters received a great number of messages from the spirit world, sometimes in the otherwise-prohibited form of visual art. The works explore very different models of women’s empowerment and creativity.

I’m in various stages of revision and development with a handful of short (and awkwardly-long) stories—and while I’m eager to give them attention, what excites me most about the summer months ahead is the potential to start something new.