John M. MacGregor is used to finding art where no one else has thought to look for it. After all, the Princeton University–trained art historian is the man who, in 1989, published The Discovery of the Art of the Insane, the first cultural history of the art of the mentally ill. He’s also the man who spent 10 years writing a 720-page book on the late Henry Darger, the reclusive Chicago janitor whose own bizarrely illustrated novel, The Story of the Vivian Girls, in What Is Known as the Realms of the Unreal, of the Glandeco-Angelinnian War Storm, Caused by the Child Slave Rebellion, weighs in at some 23,000 words.

In 1992, MacGregor was at D.C.’s National Museum of Health and Medicine doing what he does whenever he leaves his San Francisco home: trolling for outsider art. At first, the museum’s curators told him that no, they had nothing like that. Then they told him, “But we just got a shipment from St. Elizabeths”—the massive Southeast Washington mental hospital that since 1855 has housed untold thousands of now-anonymous patients.

It turned out that the materials from St. Elizabeths, which had recently closed its own museum, hadn’t even been unpacked yet. But on a list of their contents, MacGregor found a reference to a work of art done by a patient of the institution. He asked if he could see it. When it was produced, he let out what he recalls as “a spontaneous ‘Wow!’”

Inside a thick, backless wooden frame was a two-sided 9-and-one-half-by-11-and-one-half-inch piece of lacework depicting a group of variously sized figures entrapped in a web. To the uninformed, this bit of white cotton might have been mistaken for a rather embarrassing family heirloom. But MacGregor says he knew “immediately that it was an extremely important piece of outsider art. I told them right away that I wanted to photograph it and write about it.”

Accompanying the work was a yellowing file card that bore the words “Patient Art,” as well as a reference to an article by Dr. Arrah B. Evarts that appeared in the October 1918 issue of the Psychoanalytic Review. With the help of the article, MacGregor learned that the lace had been made in 1917 by a patient of Evarts’ named Adelaide V. Hall. But there the biographical trail went cold: Because of an inexplicable bureaucratic whim, sometime during the ’70s, it was decided that St. Elizabeths’ old patient records would be destroyed—except for those of persons admitted during years ending in a 5 or 0. It had been Hall’s bad luck to enter the institution—twice—in off years.

Hall’s piece of lace is both disturbing and fascinating, naive and, in its own eccentric way, remarkably sophisticated. Figures Hall identified as both male and female, for instance, possess male genitalia—in each case with the testicles placed above the penis. One of these figures also happens to be a skeleton. Another is wearing a Masonic hat and holding a trumpet.

MacGregor describes the lacework as “a masterpiece of miniaturism.” “I like things that are microscopic,” he says, “and Hall’s piece just draws you further in and further in. It’s fabulous—the more you look, the more you see.”

Look closely and you can see a dove, a bee, and several turtles. Snakes slither across the lace’s surface. One of them whispers into the ear of a figure Hall called the Woman Picking Up Apples. Another emerges from a cross to suckle at the breast of the woman variously called the One Woman, the Only Woman, and Magdalene. Seen from behind, she has long flowing hair.

Since lacemaking’s origins in 16th-century Europe, its practitioners have sometimes been inspired to include figures in their work. Examples of Italian lace from the 1500s feature sword-carrying horsemen, two-headed eagles, and other imagery understandable to the people for whom they were made. But the meanings behind Hall’s figures weren’t obvious to anyone but the artist.

“It’s asymmetrical,” says MacGregor. “Exactly the kind of thing you’d get from a spider that’s been drugged—the work goes crazy. It’s not anything like work that was being done at that time—or any time.”

According to the registry of cases for the Government Hospital for the Insane, as St. Elizabeths was called before July 1, 1916, Adelaide V. Hall was first admitted on June 26, 1901, as an “indigent.” The registry states that the artist MacGregor would eventually dub the Lace Maker was a 36-year-old white woman—and that her “form of disease on admission” was “melancholy, simple,” supposedly caused by “worry” of “two and one-half years’ duration.”

Hall was a dressmaker by trade, one of the dozens upon dozens listed in the business section of Washington’s City Directory, alongside such tradespeople as drovers, hair workers, bell hangers, artificial-eye makers, and one Roderick Danforth, dealer in “Fluids, Non-Explosive.” Hall told Evarts that she had no recollection of when or how she’d learned to sew. It was, in Evarts’ words, “as if she always knew how.”

At that time, a dressmaker might be poor or comfortably middle-class. Her social position, of course, depended on her income—which in turn depended, according to National Museum of American History social-history specialist Patricia Q. Wood, “on her skill level, her contacts, how hard she worked. One has to be careful to think of the dressmakers of that time being lower-class. Some dressmakers did very well—to the extent that they sent their children to college.”

As for the quality of Hall’s dressmaking, it’s impossible to tell: Her work has long since turned to dust. But she appears to have done well enough. The 1910 federal census places Hall at 1731 T St. NW, in a building called the Irvington. Her neighbors were clerks, stenographers, real-estate brokers, coachmen, bricklayers, and porters—even a fruit-boat pilot. Hall also lived briefly at 1608 R St. NW, which was once home to distinguished clergyman Francis Grimke and his wife, Charlotte Forten Grimke, a writer, abolitionist, and educator.

In 1901, Hall lived at 1407 Rhode Island Ave. NW. Her “indigent” status was most likely simply an expedience of recordkeeping: By law, only the indigent were allowed admittance to the Government Hospital. Indeed, 1407 was a three-story, bay-fronted Victorian in a nice middle-class neighborhood within a block or so of Logan Circle.

A wealth of miscellaneous documents tell the story of how Hall came to be declared a lunatic. A July 3, 1901, item in the Washington Post titled “Seven More Insanity Cases” set Hall’s lunacy hearing for the following Friday afternoon. However, a July 6 letter from Government Hospital Superintendent William W. Godding asked for a delay: “We beg leave to state that Adelaide V. Hall, who was admitted to this Hospital on June 26th, pending judicial investigation into her mental status is suffering from melancholia and this morning is very much depressed. In our opinion it would be detrimental to her condition to be brought to court today.”

On July 17, another article appeared in the Post, this time noting that Hall’s case would be heard on Friday, July 19. A one-sentence summation of the hearing was published on July 20. In it, an unnamed court reporter gives us our only physical description of Hall—as well as a bit of salacious detail: “Others committed were Frederick Rest, Dennis Johnson, colored; John A. Russell, and Adelaide Hall. The last named is a good looking young woman and wept most pitifully throughout the hearing.”

Hall was sent back to the hospital. Sometime during her stay, she apparently attempted to transact some sort of business, for in a December 31, 1901, letter, Godding wrote to “Mssrs. Ellerson and Wemple” to return “herewith the enclosure of Miss Adelaide V. Hall, as she is not in condition to transact any business,” and directing them to [Hall’s sister] Mrs. Heath, “who is looking after Miss Hall’s affairs while she is in the institution.”

Nonetheless, Hall’s first institutionalization was relatively brief. After a few months, she was considered healthy enough to earn money sewing for employees of the hospital. And on July 22, 1902, she was released.

Hall returned to Northwest Washington and resumed her dressmaking work. Her mental health, however, would eventually deteriorate again. She was living in the Irvington with a boarder named Catherine Tracy when, on June 22, 1911, she entered the Government Hospital for the Insane for the second time.

It was a typically sultry Washington day, with temperatures reaching the 90s. The Post dedicated its first several pages to the coronation of George V of England, providing its readers with a grandiloquent headline (“Spectacle Most Brilliant in History”), a drawing of the parade route, and lots of gossip, including the fact that the great Washington pugilist “Big Jack” Johnson “met with a clean knock-out today at the entrance to the Abbey.” Back home, a quart of Christian Xander’s Old Reserve Bourbon could be purchased for a dollar, “Continuous Vaudeville” was available at Pennsylvania Avenue NW’s Cosmos from 1 to 11 p.m., and there were “Midway Attractions” aplenty to be enjoyed at Luna Park in Arlington.

Hall was again admitted to the Government Hospital as an indigent and a dressmaker. She stated her religion as Episcopal. Her listed age was 48—a far cry from the “35” she’d told the federal census taker just a year before. Her diagnosis upon admission was “unclassified depression.”

This time, she made no fast recovery. In fact, she was in a hopeless state when she began to see Evarts in the spring of 1917: Her first words to her new psychiatrist were “I tell you no one but God almighty knows the agony I suffer, both bodily pain and heartache.”

According to Evarts’ Psychoanalytic Review article, Hall was alternately “depressed and retarded, timid, apprehensive, and anxious,” and “excited, profane in language, [and] untidy.” She experienced periods during which she assaulted fellow patients and broke “flower pots, dishes, chairs, and tables.” Unable to do acceptable work for the institution, she continued to sew for herself, making a “rag doll, with which she spent many happy hours” and using the thread obtained from unraveling her hose to make lace for her clothing.

In many ways, Evarts probably considered Hall an ordinary case of chronic and incurable mental illness—that is, until the day her patient showed her something altogether extraordinary.

Evarts was both the best and the worst therapist Hall could have ended up with. Although she took Hall’s artwork seriously enough to write about it, her analytical beliefs caused her to dismiss the truth of the terrible tale that Hall was trying to tell her.

Born in Minnesota on Oct. 14, 1878, Evarts most likely received her psychiatric training at St. Elizabeths. During her tenure at the hospital, she published a handful of articles in the American Journal of Insanity and the Psychoanalytic Review. At the time she began treating Hall, she was almost 40; like her patient, she never married.

Evarts was among St. Elizabeths’ first female therapists and an early adherent to Freudianism. But to judge by two of the other articles she wrote for the Psychoanalytic Review, “Dementia Precox in the Colored Race” and “The Ontogenetic Against the Phylogenetic Elements in the Psychoses of the Colored Race,” she was hardly advanced in every aspect. In the former article, for example, she wrote, “During its years of savagery the race has learned no lessons in emotional control, and what they attained during their few generations of slavery left them unstable.” Hall, it seems, was lucky to be white.

In her sessions with Hall, Evarts was not engaging in what has come to be called art therapy. There was no treatment as such at St. Elizabeths until 1943, although Dr. Nolan C.D. Lewis did publish several important articles about using patients’ art in their therapy in 1924. Instead, the institution emphasized a “moral treatment” that combined a restful and “homelike” environment with, for those who were capable, work. And with its 130 red-brick buildings, including an ice-cream plant, shoe- and mattress-making shops, industrial-sized laundries and bakeries, blacksmith’s shop, and farm, the hospital offered a multitude of employment opportunities.

The most agitated patients were generally administered courses of hydrotherapy—a controversial treatment that saw increased use under the hospital’s new administrator, William Alanson White. Though White doubted the treatment’s “curative potential,” he found it an efficacious calmative, both the “best possible way to do away with mechanical restraint” and a valuable alternative to such “chemical restraints” as bromide, chloral hydrate, and opium. During his administration, he added a series of “continuous baths especially aimed at disturbed, violent cases” to such pre-existing forms of hydrotherapy as spray baths, douches, and sitz baths.

White also brought to Washington some of the revolutionary psychiatric theories being propounded in Europe. A midcareer convert to Freudianism very early in his career, White made frequent visits to continental hospitals and therapists. In 1907, he even met with Freud’s young disciple Carl Gustav Jung. By the next year, according to one Government Hospital staff member, the institution was “quite charged with psychoanalytic enthusiasm.”

In this environment, Evarts was anything but blind to the pageant of unconscious desires that informed Hall’s lacework. The doctor was also working in the context of a movement that had begun approximately 10 years earlier in Germany, where Hans Prinzhorn, a therapist and art historian at the Psychiatric University Hospital in Heidelberg, had begun to collect art produced by patients.

By 1920, Prinzhorn was writing to asylums in Austria, Germany, and Switzerland in an attempt to assemble “drawings, paintings and sculptures by the mentally ill, which are not merely copies or memories of better days, but rather expressions of their own experience of illness.” Along with Wilhelm Uhde, who collected and championed the work of French customs-agent-turned-painter Henri Rousseau, Prinzhorn was helping to give birth to the concept of outsider art—work done by the insane, the visionary, the self-taught, and others existing outside the art-world mainstream.

Whether she knew it or not, Evarts was part of this process. Indeed, MacGregor considers Evarts’ article a watershed—probably “the first piece on outsider art published in the United States.”

As for Hall, she was apparently happy to explain her handiwork to her therapist. Some of her explanations were as cryptic as the art itself, but a story emerged nonetheless: about a woman who desired to be simultaneously a virgin and a mother, and whose desire for a marriage with God the Father was a sign of traumatic childhood experiences.

Each of the many figures in Hall’s lacework has a role to play in telling this story. The smaller figures include the Virgin Mary; a character who represents both St. Michael and St. Joseph; the Children of the Abbey, whom Adelaide alternately defined as a “whole race of little people” and “the Jews”; and Mr. Gibson, whom Evarts identified as one of Hall’s “early paramours,” and hence all of her other lovers, as well.

Hall’s work also features several couples. There are, as Evarts described them, “two big fat Negroes,” a man and a woman who Hall said “never wore a stitch of clothes.” Then there are a Jack and Jill, Mr. Hill and the Other Woman, and Mr. and Mrs. Hub Smith—all of whom symbolize various types of sexual relationships, from youthful attraction to comfortable middle-aged marriage.

But the most prominent figure is one that Hall referred to by a multitude of names: the One Woman, the Only Woman, Magdalene, the Virgin, the First Woman That Ever Was, the Woman Who Has Suffered All There Is in the World to Suffer Because She Wanted the Christ for a Husband. Though there is a bit of Hall in several of the figures, this last is the one she most strongly identified with. This was her self-portrait.

As her therapy progressed, Hall revealed the cause of her “agony”: a complicated, impossible relationship with her father, who had repeatedly molested her as a child. Outwardly, she expressed feelings of ambivalence toward her old abuser. Inwardly, she wanted to marry him.

Appropriately enough for a woman who was to experience more than her fair share of suffering, Hall was born into the musket fire of the Civil War and died mere months after the only war decided by atomic weapons. Her exact date of birth is unknown: Her parents lived in a rural area of Virginia where recordkeeping was a haphazard business to begin with, and the war took care of the rest when Richmond was burned in April 1865.

But she came into the world sometime in 1862 or 1863 in Confederate territory, in tiny Guilford in the southeastern part of the state. The Civil War mostly left Guilford and the rest of Surry County alone, but if she was possessed of an exceptional memory Adelaide might have been able to recall the sight of Yankee gunboats moving up and down the James River with relative impunity, past the sullen gazes of her resentful rebel countrymen.

Hall was the next to the last of nine children, at least one of whom died in infancy. Surry County had more than its fair share of infant mortality in those days, with the 1860 mortality schedule listing “Unknown” as the most frequent cause of death for small children, both free and slave. Cholera, dysentery, “hooping cough,” diarrhea, and “putrid sore throat” also claimed a number of new lives. Among the slave children, causes of death also included “poisoned” and “smothered.”

Hall told Evarts that her father was a captain in the Confederate Army, but available records indicate that he held the humbler rank of private. Serving with the 13th Cavalry under the command of Maj. Gen. J.E.B. Stuart, James Hall was a perfectly unremarkable soldier: There is no account of his being promoted or decorated, and military records note no conspicuous acts of gallantry. Instead, they show a pattern of absences and a long hospitalization followed by capture by the enemy, at either Petersburg, Va., or Hall’s hometown of Guilford, sometime in October 1864.

If he was seized in Guilford, it’s possible that, like many Confederate soldiers around that time, Hall had decided desertion was the better part of valor. Or, perhaps, that he was there to look in on young Adelaide, who would have been a toddler. In either case, Union forces ultimately sent the unlucky farmer-turned-POW north to a military prison in Washington, D.C.—the same city where his next-to-youngest would find herself confined more than half a century later.

James Hall was around 40 when Adelaide was born—which helps to explain why Hall often referred to her father as “the old, old man down in Virginia.” Adelaide’s mother, Adeline Hall, was a year younger than her husband; she died of dropsy on Jan. 15, 1869.

Left motherless and with a father whom she labeled a brutal drunkard, young Viola, as she was called to distinguish her from her similarly named mother, grew to depend on the support of an older sister, Martha L. Hall. But Martha, like most of Hall’s other siblings, married and moved away. Soon, only Viola and a brother named James were left in their father’s haphazard care. Years later, she described to Evarts beatings that left her bloody. She also called her father “the first man I ever slept with.” In fact, Hall revealed to Evarts that she slept in her father’s bed until she was 13, at which time she was taken into Martha’s household in Washington.

The 1880 census shows Adelaide, then a 17-year-old, living with sister Martha and Martha’s husband, Thomas Heath, at 1021 8th St. NW. At the time, the Heaths had three children: Lily, 2, and twins Walter and Thomas, 5 months. Adelaide almost certainly would have lent a hand in their care.

Hall’s life certainly improved materially after she left Guilford. She had moved from a remote backwater to a city that was undergoing both a rapid population increase and, thanks to the Tammany Hall–style machinations of Alexander “Boss” Shepherd, a series of infrastructure improvements that worked to the betterment of both the city and city officials’ pocketbooks.

The first telephones came into service in D.C. in 1878, and the city’s first luxury apartment building—the Portland Flats, whose prowlike design led it to be compared to “an ocean liner sailing into Thomas Circle”—was opened in 1879. The street railways underwent radical expansion, and a series of magnificent hotels such as Willard’s Hotel, Ebbit House, and the black-owned Wormley’s sprouted up to attract the rich and foreign dignitaries.

The Heath household might not have been a safe domestic refuge from the tumult. Evarts wrote that it was a “Mrs. Edward Brown,” an older sister, who wrested Hall from her wretched life with her father. But genealogical searches have uncovered no such personage, at least not with ties to the Hall family. It seems more likely that Evarts was referring to her sister Martha, Mrs. Thomas Heath. In talking to her doctor, Hall confessed to falling in love with “Mr. Brown.” She also told Evarts that one of the lovers she took during her years in Washington was a “newspaper writer of some success.” Thomas Heath was a journalist.

In keeping with emergent Freudian theory, Evarts dismissed Hall’s stories of sleeping with her father as the expression of an unconscious sexual desire—hence the title of her article in the Psychoanalytic Review, “Lace Creation Revealing an Incest Fantasy.” She also downplayed Hall’s descriptions of her beatings, describing them as “but the efforts of a misguided father to bring up his motherless baby girl.” And instead of acknowledging Hall’s early life for what it was, a kind of Southern Gothic nightmare—as her father’s financial condition worsened, he and his children were forced to live in a barn—Evarts called the Halls an “ordinary American family.”

Though a definitive diagnosis is impossible, MacGregor notes that two modern-day psychological professionals came to a tentative conclusion that Hall suffered from bipolar illness aggravated by a case of tertiary syphilis. Rebecca Hoffberger, founder and director of the American Visionary Art Museum in Baltimore, noted that “in another time, [Hall] would not have been labeled so much just as mentally ill—she was a trauma survivor.”

Still, through the lacework, Evarts was able to recognize, if not resolve, her patient’s psychic torment. To Evarts, the piece was the material representation of Hall’s permanent retreat into a world of delusions: “She has given up and has been going down and going down until she is living in comparative comfort with her incestuous fantasies. She is still suffering untold torment.”

MacGregor agrees: “In the end,” he suggests, “she’s the one caught in the webbing of that lace.” Indeed, Hall never returned from the imaginative world she created: She languished at St. Elizabeths until her death.

In the many years since such pioneers as Prinzhorn began to beat the drum for it, outsider art has become a big business. Howard Finster, the best-known contemporary American outsider artist, hung out with the likes of Michael Stipe, designed an album cover for Talking Heads, and saw his paintings shown in major museums around the world. Outsider art has gone from being the passion of a few insiders to becoming a phenomenon nearly everybody is familiar with.

As a result, it sometimes seems that nearly everybody is on the lookout for the next big artist. The celebrated draftsman Dwight Mackintosh was discovered when the septuagenarian began attending classes at Oakland, Calif.’s, Creative Growth Art Center in the late ’70s. In 1982, the entire body of work by a sculptor known only as the Philadelphia Wireman was found in the garbage. Darger’s pedophilic epic was discovered by his former landlord after the artist’s death, in 1972.

Last year, Christie’s held its first large-scale auction of outsider art, where a work by Darger sold for more than $89,000. And more than one trend-savvy young fellow of late has decided to toss his art-school education out the window in favor of making some easy money as a “visionary.”

But as MacGregor points out, for the true outsider, “[Art] is never a means of achieving recognition as an artist, exhibition, money, or fame as an artist. The process of making is all, with the object itself possessing no importance.”

In the case of Hall, the Visionary Art Museum’s Hoffberger says, “What’s amazing about her work is its poignancy. We like to say that when the life experience is too big for words, it comes out as miracles in art.”

Hall was giving vent to her unconscious through her art, but she wasn’t doing it for an audience. Indeed, after she handed Evarts her lacework, Hall seems to have forgotten about it. When Evarts showed it to her months afterward, the doctor reported that Hall “hailed it with delight.”

So far as we know, Hall never made another piece of lace. But Hoffberger notes that her museum includes many works by artists who never produced others, including a “wedding dress for…marriage to an imaginary prince” crafted out of butcher’s string by a 68-year-old woman who died the very day she finished her fantastical creation. And MacGregor insists, “All it takes is one work to be an artist. Vermeer made what, some 30 paintings? Yet if he’d made only one, do you think people would ask whether he was an artist?”

In 1999, MacGregor wrote in the British outsider-art magazine Raw Vision that Hall might have “said all she had to say in a single piece. It is difficult to imagine that, given the extraordinary interest of Dr. Evarts in her work, she would not have been given material for further creations.” What he didn’t know at the time was that Evarts left the institution the year after publishing her article about Hall, returning to her native Minnesota and a staff position at the since-closed Rochester State Hospital. “We might have more work if Evarts had stayed,” says MacGregor. “Nobody else showed any interest.”

Frustratingly, that lack of interest persists at the Museum of Health and Medicine, which has yet to put Hall’s work on display. According to James Connor, the museum’s assistant director for collections, “It’s possible that Hall’s work will be displayed at some point in the future, but there are no immediate plans to do so.”

That doesn’t surprise MacGregor. “I told them they had something on their hands that they should take very seriously,” he says. “But nobody seemed very excited. I wanted to make Hall’s piece a centerpiece of a traveling exhibition of outsider art, but they wouldn’t give it to me on loan.”

In the Europe shaped by Prinzhorn and Rousseau, MacGregor suggests, things would be different. “At Lausanne [where Switzerland’s museum of outsider art, the Collection de l’Art Brut, is based], they would give the piece the prominence it deserves,” he says. “I hope to God they realize it should be out on display.”

As the decades passed, the emphasis at St. Elizabeths shifted from providing moral therapy and a homelike atmosphere to more radical medical treatments. These included malarial therapy and various types of shock therapies, which were employed to jolt the patient back to a semblance of sanity—or, in far too many cases, merely more socially acceptable behavior. To his credit, White adamantly opposed lobotomy, telling the procedure’s chief proponent, Walter Freeman, “It will be a hell of a long while before I’ll let you operate on any of my patients.” But when White died, in 1937, many of his approaches died with him.

We’ll never know what treatments Hall underwent subsequently. Nor will we know whether she ever received any visitors—though she did outlive most of her known Washington-area relations. Her sisters Martha Heath and Mary Florence Hall died in 1921 and 1917, respectively. Martha’s daughter Lily died in 1917, as well. It’s possible that one or more of Martha’s three sons, or her daughter Nellie, went occasionally to see their aunt. Thomas Heath, who died in 1937, may have also visited. A visit from Hall’s father, whom Evarts said her patient last saw when she departed their home in the late 1870s, was unlikely at best.

What we do know, from her death certificate, is that Hall died at St. Elizabeths on Oct. 15, 1945, at 7:35 a.m., of a pulmonary embolism aggravated by arteriosclerosis and heart disease. According to the certificate, she was 82 years of age. By then, St. Elizabeths had been her home for more than 34 years.

Though many of her fellow patients wound up in unmarked and unnoted graves on the hospital grounds—in a final indignity, the information on their resting places was destroyed along with their other records—Hall got lucky: Someone cared enough to bury her in the Heath family plot at Glenwood Cemetery on Lincoln Road NE. The grave of Adelaide V. Hall, the Woman Who Has Suffered All There Is in the World to Suffer Because She Wanted the Christ for a Husband, is unmarked. CP

Art accompanying story in the printed newspaper is not available in this archive: Photographs by Darrow Montgomery.