PART 4 - SCENES FROM INSTITUTIONAL LIFE

The institution gives to the inadequate what they crave most … power


I could write about the years at Long Grove in some detail but the narrative would to a large extent become repetitious. After I had adjusted to working at the hospital, which was after a surprisingly short time, so the days drifted into each other and to some extent I developed the same tolerance for the bizarre that we all needed to successfully work there. Most days the staff saw more extraordinary behaviour than most people would see in a lifetime yet by and large it rolled off our backs as we became inured and routinised.

The hospital acted as its own village, for the staff at least, with a social club and swimming pool; the inevitable monthly magazine (of which I was editor for some time) called Brain Dead, football team, cricket team, silver band and drinking team. The latter was an important part of hospital life and involved a changeable group that regularly tried to drink the staff of the adjacent hospitals under the table at the local pubs. This was somewhat before breath-testing and I recall with horror the number of times I must have weaved my Ariel motor bike back along the lanes to the nurses home far worse for wear than was good for me – or anyone else for that matter. I didn’t fall off, well not too often, and didn’t cause major damage so I guess I was lucky. Adding to the village mentality of the hospital was the fact that many of the staff had worked there for generations, son following father, daughter following mother, many marrying colleagues and producing offspring to fulfil their inevitable destiny on the wards. It was said that male staff at least were picked for a combination of their size and/or their ability to either play in the hospital football or cricket teams or the hospital band. We students, who held ourselves a cut above the long term staff, felt the women had been picked according to the same criteria although of course this was most unfair.

The hospital as I have said, sat in its own private grounds set apart from the surrounding countryside by hedges and walls. It was dominated by the water tower but overall softened by the many trees, lawns, and generally very well landscaped and maintained gardens. Away from the D-shaped main hospital there were a number of large two-story villas that were primarily where voluntary patients, that is patients who to a certain extent were free to come and go resided. Most of the villas were built post the Second War as admission to a psychiatric hospital was expanded to include people who actually volunteered to stay there. The Villas were well laid out and most had their own kitchens so the food didn’t arrive half-cold in a large stainless trolley. They were popular to work on as they were light and airy and the patients better able to hold conversations, look after themselves and be pleasant. Most importantly though, these were the wards where some quite exciting things happened that were fascinating for our unsophisticated minds. This was the middle of the 1960s and a time of great experiment in understanding of the human condition. The villa wards provided a readymade population for the bright young psychiatrists and psychologists to try the latest therapies described in the journals. Psychotherapy of course, in all its many forms, group therapies, hypnotherapy and drug induced abreaction, electroshock therapy or ECT and of course trial after trial of the drugs that began to flood the psychiatric market in those days. All in all a fascinating place to work as long as you left your mind in neutral, discarded professionalism to the winds and there wasn’t an Ethics Committee in sight. The main block wasn’t immune from experiment either but here the experiments were more brutal; lobotomies and habit training, malarial therapy, prolonged narcosis, new ‘improved’ anti-psychotics that would leave patients drooling and comatose, insulin shock treatment and of course ECT. The main block wards still had padded rooms and straightjackets although on the whole the latter weren’t used very often as in spite of what you see in films or read in books they are fearfully difficult to get on to an agitated or violent patient.

I have thought at length how to summarise my four years at Long Grove and in the end decided to break things down into a series of scenes that are each representative of the culture that prevailed at the time. I have neither exaggerated nor minimised; nor have I drawn conclusions, those you can draw for yourself.

Jenner One Breakfasts

Jenner One was Long Grove’s Refractory Ward - the ward that held the most difficult patients or those who needed the highest level of security. In layout it was much the same as any other ward except that the side rooms in the gallery were a combination of full-pads or half-pads. Full-pads were padded rooms that were lined with padded leather to the ceiling. The floor was similarly padded so although not soft, it was hard for anyone to harm themselves and the leather made the surfaces impossible to damage with bare hands. Where the floor met the wall was a gutter that led to a drain in one corner and what light entered the room came from a small window high in the wall and just out of reach. These rooms had two doors. An inner padded door with a peephole and large, polished brass bolts that opened against a spring so that if the door was slammed shut they would snick into place. There was a gap of about 12 inches between the inner door and the outer door. The outer door was solid but otherwise conventional enough and secured with a ubiquitous asylum lock recessed in its small brass cup. Half-pads were similar in that they had the high window and two doors but in these rooms the padding was on the floor and only about half way up the walls. Padded rooms were for people who were overtly violent and in danger of hurting themselves or the staff and the half-pads were for people who were usually so medicated that they were incapacitated an the padding was there to prevent them rolling into the wall. Both types of room had no furniture and bedding usually comprised two to three blankets that were stitched together in a narrow quilting patter so that they could not be torn.

Jenner One was staffed more than the other wards but only with the addition of one or two extra nurses – medication did much to calm things down in those days. But to get back to breakfast as this was legendary, not only at Long Grove but throughout the whole asylum system as I heard stories about them in many other hospitals. “Oh, you worked at Long Grove did you? Ever work on Jenner One, I believe the breakfasts were amazing …” or some such.

The principality of Jenner one was presided over by Richard (Dicky) Birdd, a charge nurse of the very, very old school. He was a surprisingly small man, barely above my shoulder, but he ruled the ward with a rod of iron.

I have mentioned that each ward had a storeroom and it is here that the Jenner One breakfasts were held. In the middle of the room was a large wooden table that sat about eight people in comfort. The famous Breakfast began after the patient’s breakfast and things were quiet. The ward was left in charge of the two most junior students and the remaining staff retired to the store. The key ingredient was Hartley who was a long term patient of Jenner 1. He had worked as a butler for some moneyed family until for some unknown reason he had taken a shotgun from the gun room and shot not only his master but the cook and the stablehand. (Yes indeed, the butler in this case really did do it!) All three fortunately survived although it was very much touch and go for the stablehand. Hartley was found guilty but insane and committed to Long Grove’s Jenner One where after a period of time he once again resumed his butlering duties.

First he would carefully iron two white sheets and drape them over the table as a tablecloth. He would then bring from its special box in the store the staff cutlery that over the years he had lovingly polished to a gleaming shine. This would be laid carefully for each member of staff with the main place setting of course being reserved for Dicky Birdd at the head of the table.

Next to arrive would be several boxes of cereals. Two large milk jugs were filled to the brim with the cream off the top of all of the milk bottles that had been sent to the ward for the patients. Usually there were also tinned grapefruit served in small glass bowls and a glass of juice at every place. The staff would arrive and take their places while Hartley would hover around pouring tea or coffee and making sure the first course was all that was required. The table would then be cleared to make way for toast and jam and the main event which was the cooked breakfast. Even after all these years I cannot recall a breakfast to meet the standard of those served by Hartley and although I have some tinges of regret for my acceptance of this at the time, it was simply part of the milieu and the essential fabric of Jenner 1.

The main course was magnificent. Hartley had carefully saved potatoes from the previous night’s dinner and these were fried to a crisp, golden brown. In addition there was bacon, eggs, sausages, baked beans and tomatoes. Most of the food was originally intended for the patients but Hartley had intercepted the very best and kept it aside for the staff. If fish had been on the ward menu the previous day Hartley would make kedgeree or fish pie with potato and eggs and peas, sprinkled with cheese and grilled to perfection. The cereals eaten, the cooked course cleared away and in would come coffee and croissants that Hartley had baked himself in the ward kitchen. By this time we were replete but undaunted and the croissants went down with as much enthusiasm as everything else. Following the eating part of breakfast would come the yarns and the gossip with Dicky Birdd a mine of information and a fount of stories of his years in ‘The Bin’ as he referred to the hospital. I am sure many were exaggerated for effect, or at least I was when merely a first year student, but as time went on I found that my experiences although different, echoed Birdd’s.

Then after about an hour or so, Dicky would look at his watch, mutter something about getting back to loony-land and he would saunter back to his office and we would resume ward duties. Hartley would clear the table, carefully wash the cutlery by hand, pouring boiling water over the knives and forks as instructed by the fastidious Dicky Birdd who was always worried that somehow the staff would end up using the same utensils as the patients.

While on the subject of breakfast and noting the largesse the staff enjoyed I also recall one Christmas Day when I was on morning shift on Jenner 1. The main kitchen had the temerity to send up to the ward a choice of food for the patients – a large pot of porridge and a bowl of tinned grapefruit. Such items never came together but being Christmas the kitchen obviously was feeling generous. Dicky Birdd wandered into the ward kitchen where I had been dishing grapefruit and porridge out according to the preference of the patients. He elbowed me aside, picked up the grapefruit and poured it into the pot of porridge saying quite simply that “ … they don’t have a choice on my ward, Laddie.” He walked back to his office full of indignation and I was left to serve the mess to the patients who in the end didn’t seem to care anyway; they knew Dicky Birdd of old I suppose. Should I have said something? Maybe. But this was so typical of the environment that it is surprising how quickly one came to accept such situations with a mental shrug and mark it up as one more point to the institution, one less for the patients.

On the whole though, Christmas was a good day to work even if it did mean being away from family or friends. The wards were decorated enthusiastically by the student nurses, grudgingly by the more senior nurses. A Christmas tree, some small presents so that each patient had something to open on the day even if only a bar of soap or some such. The staff smuggled in large amounts of booze – the hospital was supposed to be dry on the wards but of course it never was – and we tended to while away most of the day when not exactly involved in essential duties either in the store or the office. Jenner breakfasts on Christmas Day surpassed even their usual grandiloquence and Hartley would find all sorts of treats, mince pies, Christmas Cake and other goodies so that breakfast was a sort of continuous feast lasting much of the day with minor interruptions for medication rounds or lunch.

I think Jenner One breakfasts lasted long after I left Long Grove. I did hear that one day a visiting Inspector of Hospitals called unexpectedly and put an end to them but the whole ceremonial was so entrenched that probably they ended because Dicky Birdd retired or Hartley died. But when I left they were firmly established as part of the routine and ultimately the mythology of Long Grove.


Crime and crime again

I was at Long Grove during the early sixties. Gang warfare existed on the streets of the East End and notorious among the criminal elite were the brothers Andy and Johnny Park. Andy was, in the words of Dicky Birdd “... as mad as a snake” and had been committed as a Special patient to Long Grove following his abortive attempt to knife to death a rival gang leader following an argument in a public house in Bow Road. Andy was certainly odd. I cannot recall his diagnosis but it must have been something to do with a paranoid psychosis as he would pace the ward looking around furtively and constantly complaining that the KGB were spying on him with microphones hidden in the ventilation grills near the ceiling. He was of middle height, around forty years old, well built and had a pugilistic look enhanced by the broken nose and cauliflowered right ear. We kept a weather eye on him as he was quick to violence and this propensity had been useful in his role as an enforcer on the streets and in the Clubs of London’s East End. Yet for all his brute strength and presence Andy was putty in the hands of his ageing mother, a tiny woman who ruled both Andy and Johnny with the lightest of words. Like many in such positions it did seem that their mother had an inordinate role in their lives and they always seem to have a soft spot for older people; indeed Andy and Johnny’s empire included a significant role in supporting the ‘old folk’ on their manor and there were always the Christmas parcels, coal during the winter, repairs to the plumbing and other small things that made a real difference. A strange contrast; on the one hand a violent and brutal empire built largely on racketeering, protection and prostitution and on the other an informal welfare system. One only had to give one of the brothers the nod about an elderly person in strife and matters were quietly and discretely managed. On the other hand a similar nod about a ‘grass’ or ‘snout’, to use the argot of the day for informers, saw more than one poor individual disappear, so rumour had it, into the foundations of the nearest Motorway.

Andy and his brother Johnny were alike as two peas in a pod, even down to the broken nose and the cauliflower ear. They had both been bare-knuckle boxers in the illegal fights n some of the less reputable gyms and wore their scars proudly. Andy used to say that if one didn’t like the look of his face then you should see the other guy. Johnny, although physically a close model of his brother, was the smart one of the two. He ran the rackets, Andy did the enforcing and it seemed to be an arrangement that worked to their advantage. After Andy was admitted to Long Grove Johnny would visit each Sunday driven to the hospital in his white Jag. Summer or winter he would wear a snap-brim hat tipped jauntily over one eye and a tailored camel coat with beaver collar. He would be accompanied by two of his minders, usually giants of men who would stand either side of him with their hands clasped in front of them and jumpily looking around to protect their master from any real or imagined threat.

Each visit followed the same routine. The ward doorbell would ring and Johnny and his minders would be escorted to wherever Andy was in the ward. If the weather was fine they would go into the yard where Dicky Birdd would make sure there were no other patients or visitors so they could have it to themselves. If not, they would sit in Andy’s side room and smoke while the minders stood outside the door like sentries. When he left Johnny would stick his head into Dicky Birdd’s office, thank him for looking after his boy and discretely pass across a folder five pound note that just as discretely seemed to vanish into Dicky Birdd’s pocket. Johnny and his retinue would then leave the ward almost like visiting royalty, nodding at the staff, waving at Andy and closing the door behind them to an audible sigh of relief from the staff.

On one particular Sunday the routine was much the same. Johnny arrived in his white Jag with his minders. As it was raining quite hard he spent the usual hour with his brother in the side room and then with the usual ceremony left the ward, passed the five pound note to Dicky Birdd in the office and sauntered out puffing a cigar.

About ten minutes later Andy walked into Dicky Birdd’s office and announced that he was off then. Dicky told him not to be stupid and to get back down the ward at which Andy announced smugly

“You’ve got it wrong Dicky me lad, I’m not Andy, I’m Johnny. What’re yer going ter do abaht it then?”

Dicky Birdd, it was reported later was a model of composure. What had happened of course was that Johnny had simply swapped his coat and hat with his brother, waited ten minutes until his brother was safely off the property and then turned up at the office. Naturally Johnny wasn’t a Special patient so couldn’t be held. Dicky Birdd looked thoughtful for a moment and replied,

“Why, nothing at all, Johnny …” and personally escorted him off the ward from whence neither Andy nor Johnny were seen again; well not at Long Grove that is.

To my surprise nothing at all happened. The Police weren’t that interested in picking yet another fight with the brothers and Andy more or less behaved himself for all of a month until he was once again arrested for another violent attack. This time there was no soft option and he was sent to a secure psychiatric facility where he remained until he died some years later. A couple of years went by and Johnny was arrested and sent to jail. That was really not only the end of their empire but also to a large extent the end of organised crime in London for many years. To many the brothers were a great paradox. Quick to anger and unrelenting when it came to violence against those who crossed them, yet on the other hand quite genuine tears and sadness when someone under their wing was ill or dying. I remember Andy as a man to be watched very carefully and we all trod on eggshells in his vicinity so I wasn’t too dismayed at his leaving, however unusual the events. Types like Andy and Johnny no longer exist and have been overtaken by organised gangs of immigrant mafia who deal in drugs; the brothers wouldn’t touch such stuff for in their own funny way they had certain lines over which even they wouldn’t step.

In my travels around London’s East End where I later worked for a while I would occasionally see Johnny sitting in the back of his large white Jag, smoking a cigar and waving at passers by of his acquaintance a bit like a dangerous version of Arthur Daly. He was certainly no loss when he was finally removed from circulation but his flamboyant life-style and the myths and legends that abounded about the brothers have left a lasting legacy and even some small affection. Andy remained a further ten or so years in the secure hospital until he died of cancer. The funeral was attended by many hundreds of people including one or two politicians, a scattering of well known actors and Johnny who attended under escort form prison. The cortege stretched for at least a mile through the London Streets to the Bethnell Green Cemetery and I remember the coffin with its huge bouquet spelling out the words ANDY in yellow daffodils. Johnny stood at the graveside a shadow of his former self, thin and hunched against the wind and wearing a suit that would have once fitted but was now a few sizes too large. He tossed a handful of earth on the coffin as it was lowered into the ground and following the simple ceremony he pulled his shoulders proudly back and looking neither to right or left was led back to the waiting Police car and out of my life for ever.



The Repair Shop

I think it was in my third year at Long Grove and I was working nights on one of the ground floor wards, Hunter One. This was one of the long term wards for people who on the whole were fairly easy going and needed only minimal supervision. There were the usual smattering of post-lobotomy patients, perhaps twenty or so Poles (I will return to them later), an old sea captain called of all things Jonah T----, several people with long term melancholia or more correctly intractable depression and a number of people who had simply grown old there. It was an easy job for one nurse. The patients usually began to take themselves off to bed around nine after I had wheeled round a trolley of cocoa that I poured into large china mugs from a white enamel jug. One or two would be quietly snoring in their chairs and I would wake them up and prod them gently to their beds but apart from that I had little to do. I enjoyed nights as I used the quiet hours to write assignments and generally catch up on study and I was something of a night owl anyway, possibly a delicate prodrome to the depressions I suffered later in my life.

After the patients were settled I would either watch television in the lounge or retire to the office and my text books. The night would pass with little incident; there were always one or two patients who I had to rouse out of bed two or three times throughout the night and take them to the toilet so they wouldn’t be incontinent but that was all. From time to time the Night Supervisor would call in making sure she rattled her keys noisily in the lock so as to wake up any nurse who may have, horror of horrors, been asleep on duty.

The night in question was interrupted at about midnight when Sam the nurse on the upstairs ward knocked on the door of my ward and asked if I would give him a hand to fit his motor bike into the lift as he was planning to strip down the motor and do some repairs while on duty. We struggled the heavy machine into the lift and I left him to it once we had manhandled the bike out of the lift and wheeled it into the gallery of Hunter Two.

Round about midnight and if the ward was settled I would usually wander upstairs and for about twenty minutes share a coffee and a yarn with the nurse on duty. This I did that night and there was Sam sitting on the floor of the gallery with his bike in bits carefully spread out on a sheet that was now well marked with oil. We chatted quietly and I finished my coffee, returning downstairs thinking that it was a bit strange but overall in keeping with the madness of my environment. Sam would have fitted the category of a chronic old school nurse. He was an attendant rather than a registered nurse but had worked at Long Grove for nearly thirty years. He was an easy going if somewhat lazy man and would always be the first off for his break and the last to return. He was generally well liked and seen as a bit of a rogue always quick with a joke or some other outrageous tale of life in the hospital. So to see him quietly striping and rebuilding his motor bike was as much in character as his habit of bringing in his dirty underwear, throwing it in the ward linen basket and helping himself to clean from the store. He reasoned that he was not actually stealing it as he always returned it for washing thus it was merely borrowed!

I was woken from a shallow doze by an unusual rumbling sound and as I struggled awake I realised that it was a motor bike revving up above me. Sam had obviously got the bike together and was running the engine to make sure everything worked. I looked at my watch; half past four in the morning. I thought this was hardly fair and picked up the phone to call upstairs. By this time I could hear the bike trundling slowly up and down the upstairs gallery no doubt on a test run. Then a loud crash and the bike engine stopped. From upstairs there came some scraping sounds, furniture being moved and other indeterminate noises. Then silence.

After a couple of minutes the phone rang. It was Sam. He was agitated and muddling his words but the gist of it was that he’d had an accident and could I pop up and deal with a cut. So I went upstairs to find Sam’s bike back together and on its stand outside the office. Sam seemed OK but he pulled me urgently down the ward to one of the side rooms where a patient sat on the edge of the bed with blood oozing from a deep gash over his right eye. Apparently he had been woken by Sam’s bike and stepped out of his room where he had encountered Sam and his bike and had come off somewhat the worse for wear. I cleaned up the cut, put in a couple of stitches as I had only recently been taught to do and helped settle the poor guy back into bed.

Shaking my head in despair I helped an apologetic Sam to get his bike downstairs and parked in the yard. He kept asking that I wouldn’t tell anyone would I … more than his job was worth and all that. I assured him I would not, went back to my ward and eventually finished the shift.

And that should have been the end of a rather bizarre incident in a series of bizarre incidents but it was not to be. I finished my stint of nights and a few days later was back on day shift, coincidentally on Hunter Two. The ward physician, Dr Swan, was running through the routine P & M (physical and mental) examinations that were supposed to happen for long term patients at about six monthly intervals. It was usually a quick once over with an MSQ (Mental State Questionnaire – a series of ten common knowledge questions such as who is the Prime Minister to determine contact with reality). Are the meds OK? Any other problems? Anything we need to do? By chance the first person on the day’s list was the patient I had recently stitched up after the motor bike incident.

“Hello Jim,” aid Dr Swan in his kindly way, “you seem to have cut your eye, how did that happen?”

“Well,” said Jim in his nasally voice, “I got run’d over by a motor bike.”

“Oh dear,” replied Dr Swan, “where did this happen, in Epsom?”

“No doctor – in the gallery”

Dr Swan looked puzzled and tried to elicit more information but Jim stuck to his story. He had woken up at night, stepped out of his room and been run over by a large red motor bike. I said nothing but did feel acutely embarrassed as I did not want to add anything in case Sam was compromised. To my eternal shame however Dr Swan just checked the stitching, said they were quite tidy and asked me to make sure they were removed. Jim left the office and Dr Swan wrote in Jim’s file “Physical state NAD (no abnormality detected), mental state somewhat delusional and appears to be deteriorating.” Dr Swan was all for increasing poor Jim’s medication but I at least said we’d just keep an eye on him and let’s only change it if he becomes more unwell to which fortunately Dr Swan agreed.

I ran into Sam some time later and told him about the examination but Sam only laughed thinking it a huge joke. I don’t think it did any lasting harm to Jim; he remained at Long Grove for a few more years until eventually being discharged into one of the new community care houses where I believe he did quite well. At least his nocturnal perambulations would have been less fraught with risk.


The Darkest Fear

Phobias are all too common, not only among the residents of psychiatric hospitals but within all of us. We each have our secret or not so secret fears. Our room 116. Some of us fear spiders and at its extreme this fear is called arachnophobia; others the dark, achluophobia; and still others fear crowds, agoraphobia. If the fear was crippling enough it could, in the early sixties at least, lead to admission into the dubious treatment regimen of a psychiatric hospital. Long Grove was no different and most wards had their smattering of patients who were paralysed with some fear or another.

Jonah the sea captain I have already mentioned was one such. His abiding fear was of anything to do with switches or buttons. He was incapable of switching on a light or any electrical appliance and if you think about it this would be very inhibiting in today’s world. He was also beset by the most bizarre hallucinations often seeing himself back on the deck of his destroyer ploughing through the North Atlantic. He would roll his way along the gallery swaying from side to side as though staggering on the bridge of a ship at sea and call to his imaginary crew to “Man the forrard guns for God’s sake, they’re at us again …” and then duck down behind a table to peer suspiciously at some imagined foe. He was quite harmless and apart from this little eccentricity was a delight to talk with. In his more lucid moments he would tell of his war, of the long convoy patrols in the freezing northern waters, of the constant fear of U-boats, of the despair at watching ship after ship go down and seeing some of the most terrible sights imaginable. He talked of men in the water, incinerated alive in the inferno of burning oil from an exploding tanker, of watching me jump into the water from sinking ships and knowing they wouldn’t last more than a few minutes in the freezing water so there was no point even trying to rescue them.

Jonah had no family, or if he did they never came near, and apart from an occasional outing to Epsom in the company of one of the nurses he would spend his days in the ward pacing up and down and dreaming his nightmarish dreams. One of the female nursing assistants took an especial shine to Jonah and they seemed to have a real friendship. His eyes would light up when she came on duty and he appeared a different man pulling his shoulders back and replacing his stagger with more of a nautical swagger. Jonah had been a good looking man once and one of his proudest possessions was a photo of him on the bridge of his destroyer, duffle coat pulled tight against the wind, his cap at a jaunty angle. It was hard to reconcile this young, vibrant and obviously intelligent fighting man in the photo with the sad caricature of his former self that walked the wards.

Jonah’s diagnosis was uncertain and he seemed to have one of those indeterminate psychotic conditions that could have been brought on by the stress of convoy patrol, organic change or schizophrenia. His history made him popular with each new psych registrar who came onto the ward and each tried to outdo their previous colleague with a new slant on his diagnosis so that it would swing between bi-polar disorder, disassociative state, paranoia and paranoid schizophrenia. I’m not sure any of them were right but this multiplicity of diagnoses was common for many of the patients. Psychiatry was, and possibly still is, somewhere between art and science so that interpretations of behaviour are subjective at best.

His fear of switches made his life complicated and at night one of us would have to go to his room to turn off the light, to turn it on again in the morning. We even had to turn on and off his shower as his fear seemed to extend to faucets as well. Working at the hospital at that time was a doctor Tom Heinz, who was particularly interested in hypnosis and he and I teamed up as we shared a mutual interest and I had been training in Eriksonian hypnotherapy at the Tavistock Institute. Tom and I often worked together with me being mentored into some crude level of competency. Naturally we became interested in the development of phobias and for some time attempted to use hypno-analysis to improve our understanding and then follow this up with hypnotic desensitisation In other words placing patients into a hypnotic state and then talking them through increasingly ‘risky’ situations associated with their phobia. A person phobic about spiders, for example, would be given the suggestion while hypnotised that they could see a cobweb in the far corner of a room. When comfortable with this suggestion they would be told they could see a spider in the web and so on until they were comfortable with the suggestion that they could hold a spider in their hand. I’m not sure if there were lasting effects but we had some success in the short term at least.

Jonah was one of our patients and for a long time we endeavoured to establish the cause of his phobia of switches by taking a convoluted journey back through his life during increasingly deep hypnotic trance states. The answer, when it eventually came was simple but shocking.

In one session Jonah was recounting convoy escort duty in the northern reaches of the Atlantic. Mid-winter, water so cold that a man in the sea would die in minutes. A calm, icy night with stars gleaming like a million unflickering torches. Jonah was asleep in his cabin when the action stations siren went as a submarine periscope had been briefly spotted by a lookout moving through the limpid waters. Arising from his bed, still groggy from his constantly interrupted sleep he reached for the light switch and turned it on. At that very same moment the ship shuddered with an enormous explosion as it was hit by a torpedo. His ship rapidly foundered and Jonah spent nearly forty minutes in the sea miraculously being picked up by another ship more dead than alive.

He never fully recovered from his ordeal and was left with a phobia of switches that seemed to stem from the juxtaposition of the torpedo strike and his turning on the light. On his eventual return to England Jonah was a broken man and eventually found his way from military hospital to Long Grove where his fear of switches incapacitated him and his now distorted view of reality saw him constantly pacing the swaying deck of his destroyer facing down an eternal enemy.

Whether our new understanding of the cause of his phobia was any use apart from academic interest I remain uncertain. I know that for a long time we tried to desensitise him but with no success. Tom felt that the psychotic overlay inhibited our treatment but maybe there are areas where for all our skill we are helpless in face of the complexities of the human condition.


The Poles

The Poles as we called them were an interesting and sorry bunch of people. Many of them had limited English and so conversation was difficult. Occasionally a harassed looking interpreter would accompany the patient in an interview with the doctor but somehow this only seemed to confuse things more. Medication and other treatments were thus as much as by guess or by God and so the Poles featured as having some of the most flamboyant and bizarre behaviour of any of the patients. Some of this we put down to a racial personality type of the excited and excitable eastern European. But it was probably as much our attempts to treat and the terrible situations that many of them had experienced during the then recent World War.

One I remember in particular as his English was quite good and he would spend long hours with me when I was on nights whiling away the small hours when he couldn’t sleep with some of the most harrowing tales. His name was Petrus Zzy*** And among other things as he had so many Zs and Ys in his name was known for having the last name in the telephone book and at one time featured in the Guinness Book of Records. But that aside Petrus had spent the period after the invasion of Poland firstly as a Captain in the Polish Army and when that was defeated as a partisan fighting a dark and bitter guerrilla war in the forests of southern Poland. He saw sights that would ‘harrow up your soul’ and fought against incredible odds with poor equipment, ragged clothing but a dogged determination. In time the Germans took to killing fifty civilians for every German soldier killed by the partisans and to some extent this took some of the enthusiasm from the fight and gradually the partisans disbanded or were captured or killed or both. Petrus was eventually caught and sent to one of the more notorious concentration camps where he survived for three more years.

Eventually Petrus and a number of his skeletal colleagues from the camp were packed into trucks and driven into the forest where they were lined up alongside a trench that had been dug by a bulldozer and already was lined several deep with bodies of other unfortunates. The SS then opened fire on the prisoners and they dropped dead and wounded into the trench. Petrus was miraculously wounded with a shallow injury across his scalp but which bled profusely. Falling into the trench he lay motionless and waited for what he thought would be the inevitable coup de gras but the SS troops simply sat down and smoked. The trucks left, presumably to get more prisoners and then the heavens opened and it began to pour with rain. This forced the SS troops into the tree line to take shelter and covered by the falling rain and in the by now gloomy afternoon, Petrus dragged himself from the pit and lay under some bushes where he could watch what was happening but not be seen. During the course of the day four more trucks with probably a hundred more prisoners arrived at the awful scene and all were gunned down into the pit. The bulldozer then started up and pushed the soil over the sprawled bodies even though some were clearly still alive.

Petrus watched from his hiding place until the troops eventually left, laughing and joking as though they had been at a social function and completely unaffected by what they had done that day. As the night drew in Petrus eased himself from his hiding place and staggered into the depths of the woods. One has to remember that this man had somehow survived three years in a concentration camp; he was skin and bone, infested with lice, covered with sores and a shadow of his former self. Emaciated, malnourished and exhausted he staggered and fell across some miles of countryside over the next months living on scraps of turnips and potatoes found in the waterlogged fields. He kept himself warm by wrapping himself in a rotting horse blanket he found in a ruined barn and sheltered at night under the dripping hedgerows or in the occasional ruined house that he found. He was constantly evading German patrols and even local peasants in the fear that he would be turned in. Eventually his wanderings took him all the way into Slovakia and in the mountains, more dead than alive he was found by a small band of Slovak partisans. Petrus gradually recovered his strength living in a cave with the partisans and in due course was well enough to handle a gun and join in their raids as they harassed the by now demoralised and fragmented German troops.

However for all his incredible tale of survival Petrus was left badly scarred by the experience and increasingly took to spending long hours outside the warmth of the cave and lying under bushes or just standing on the skyline talking loudly to whatever daemons were invading his increasingly disjointed mind. This was not useful behaviour and could have attracted unwelcome attention from the occupying forces and so eventually he was held more or less captive in the cave.

With the eventual liberation Petrus was once more on the move and to escape the Russians this time, he and a number of the partisans made their way to Austria where Petrus’ by now very frank and overt madness was beginning to be a real problem. As an ex-Polish Army Officer he was placed in a British Military Hospital and for some bureaucratic reason eventually transferred to England, ending up with several hundred others of his countrymen in Long Grove.

It is easy to write this tale some sixty years after it happened and in the warmth and civilisation of my library but one has to remember that this was very real and that many people like Petrus didn’t survive. It is hard to imagine how he crawled and staggered across so many miles of cold, bleak countryside living on scraps and in constant fear of capture. It is hard to imagine how any of us would have coped in the same situation. But Petrus was a survivor an in spite of his psychosis he showed a determination and strength of human spirit in the face of adversity that few of us could match.

By the time I met him he had been in Long Grove for about fifteen years and was settled into a quiet routine. His hallucinations were constant and from time to time he would burst into Polish, shouting and gesticulating to the world. While terrible I am sure that Petrus’ tale would have been representative of many of the Poles at the hospital but few of them communicated as their English was generally very poor. I do know that many were orphans of the concentration camps and had been sent to England after the liberation simply because no-one really knew what to do with them. Many of course were so traumatised that they were incapable of living a normal life and it is probably moot whether one could say they had a frank psychiatric illness or simply lacked the skills and confidence to make a life for themselves. Either way they had settled into the routine of the institution and when I left there was little hope on the horizon for any of them. No doubt over time they became part of the great experiment called deinstitutionalisation but after all of the years they had spent in the camps and then the hospital one cannot but help wondering how they eventually fared. Not very well I suspect.