A perfect turmoil Walter E. Fernald and the struggle to care for America's disabled

Green, a Harvard lecturer on public policy, debuts with an enthralling biography of Walter E. Fernald (1859--1924), a controversial doctor who shaped much of 20th-century American government policy toward the disabled. As the superintendent of what was then known as the Massachusetts School for the Feeble-Minded (now named for Fernald), he introduced a humanizing new standard of care (insisting, for instance, that residents no longer be referred to as "inmates" but "patients," and providing more accurate diagnoses to aid in "treatment") but also became increasingly involved in promoting eugenics. Fernald stridently argued for institutionalization on the grounds that disabled people were a social "burden," laying the foundation for the mid-20th century's system of mass institutionalization; he also institutionalized women and girls for nonconformity. But later in life, Green writes, Fernald made a remarkable turn, decrying both institutionalization and eugenics, and calling for a "decentralized" system of "collective" care for the disabled--a "radical" proposal at the time, Green explains, that was also deeply prescient. Green's excellent dissection of Fernald digs into the internal contradictions and social forces that made it possible for one man--and for the modern world itself--to make such a drastic shift. The result is a gripping intellectual history of a major societal sea change. (Apr.) Correction: A previous version of this review incorrectly stated that Walter Fernald practiced eugenics and forcibly sterilized patients.