Dorothea Dix was a woman of striking paradoxes. A lady of dignity and refinement, she spent her days investigating the squalid world of madness, probing the nation's worst hellholes. Professing conservative feminine values, with furious energy and keen political insight, she invaded the masculine realm of government to press her agenda. Indeed, the secret of her success was to use conventional rhetoric of female subordination and self-denial to camouflage her radical course of political action.

A woman of profound religious conviction, Dix believed that God had called her to a divine mission: to become the voice of the mad, speaking for those unable to speak for themselves. Accordingly, she threw herself into her vocation with an all-consuming intensity. Obsessed with the insane, she all but ignored the most celebrated reform movements of her day, women's rights and antislavery. This has led most historians to underestimate her.

Yet no Victorian woman matched Dix's record of concrete achievement nor lived a more intrepid life.