On a cold day in March of 1911, officials marched twelve Black men into the heart of a forest in Maryland. Under the supervision of a doctor, the men were forced to clear the land, pour cement, lay bricks, and harvest tobacco. When construction finished, they became the first twelve patients of the state’s Hospital for the Negro Insane. For centuries, Black patients have been absent from our history books. Madness transports readers behind the brick walls of a Jim Crow asylum.