My Story
Page 17
The few local residents had been alarmed by the mass escape of patients from the ‘strong box’ and complaints were made to MPs and newspapers. But shortly after, two inmates, Daniel McLean and Alice Kaye, made permanent escapes from Broadmoor.
In those early years, male patients were kept in six blocks and female patients in two. In all there were about four hundred people in the hospital. It was impersonal and inhuman and all patients were known by their serial numbers. When they came here they virtually ceased to exist as individuals. They had no visitors, no names, no identity, just a number. They were truly better off dead. When they died the serial number, not their name, was engraved on the tombstone. Before the dead were buried, though, their brains were removed so that the hospital doctors could dissect and study them in a bid to learn more about insanity and what caused it.
One brain they would doubtless have enjoyed dissecting, though they never had the chance, was that of a particularly violent murderer called William Bisgrove. He made history by becoming the only murderer to escape successfully from Broad¬moor, and even his flight was marked by violence. On 12 July 1873, Bisgrove attacked a nurse while he was out exercising in the grounds, clambered over the garden wall and ran off into the woods surrounding the hospital. He was never seen again. After his escape security was greatly tightened up and freedom of movement became even more restricted.
But the unhappiness of the patients and the violence against senior members of staff continued even after the demise of the ill-fated Dr Meyer, who was replaced as superintendent by Dr Orange. In 1882 Dr Orange was attacked by the Reverend H. J. Dodwell, a genuine man-of-the-cloth who had become mad and had been inside Broadmoor for four years after attempting to shoot the Master of the Rolls. He had failed in that attempt and also failed to kill Dr Orange, though the latter was forced to retire through ill health shortly after.
This attack resulted in an official investigation into why the patients were venting their anger on hospital officials. The report which followed concluded: ‘In the lunatic domain the Superin¬tendent acts the role of the king. The inmates see themselves as victims of injustice and authority. The inmates see the Superin¬tendent as the Authority. That is why they attack him. They rarely attack each other.’
The report was correct in its conclusion that patients ‘rarely attack each other’, because that is true. But there are always exceptions to every rule: in 1946 one patient hit another on the head with a bottle and killed him. It is not surprising that those early patients became so upset. There was no kindness or therapy, in those days, and they were simply caged and treated like animals, probably rather worse. There was also much use of mechanical restraints, padded cells and strait-jackets. Even the official description of the strait-jackets used years ago at Broadmoor has a chilling sound to it: ‘Boiler suits of stout canvas fastened behind the neck. Material stiff enough to impede brusque movements and tough enough to prevent the wearer from tearing it to ribbons.’
Nothing changed for the better until 1920 and the arrival of a superintendent called Dr Sullivan. He appears to have been the first man in the history of the hospital who cared about trying to make the patients happy and trying to make them better. He started experimenting with therapy and rehabilitation and also with drugs to calm upset patients. Even in his reign, though, Broadmoor was still a primitive place. Razors were forbidden and all of the patients were unshaven. That alone must have led to them being uncaring about their appearance. The no-shaving rule did not change until as recently as 1944, and then only in some blocks.
Patients’ visits, from relatives and friends, a vital part of the rehabilitation of every inmate, weren’t introduced until 1926. Until then, the moment you were locked inside the hospital you lost all contact with the outside world, except by letter. Visiting was introduced by Dr Foulerton who replaced Dr Sullivan in 1926, and relatives were allowed to see patients on one Sunday every month. Sadly it seems that many didn’t receive any visitors, such was the stigma attached to mental illness in those unenlight¬ened days. Many people were ashamed to have relations inside the hospital and to be seen entering it. Few cared to admit they had a husband, father, or other relation who was mad. They simply ignored them and stayed away.
The first real Broadmoor revolution probably started under Dr Hopwood who took over as superintendent during the Second World War and stayed until 1952. Hopwood introduced electric shock treatment - and sport. Suddenly patients who had been more or less confined to their blocks apart from a daily supervised walk were allowed to play football, basketball and bowls. Later, they were even allowed to take part in whist drives, and occasional dances to which the hospital’s female inmates were also invited. A choral society was formed - concert parties took place from time to time - and even a drama group, The Broadhumoorists, who still put on plays today. Four thousand people see their shows every year, including many members of the general public, although the cast has to adopt fictitious names. They do comedies, drama, which sometimes involves stage murders, and even Shakespeare. These days the actors are sometimes coached by professional actors and members of the Royal Shakespeare Company, who give up their spare time, free of charge, to come to the hospital to give advice. When that news got out recently some people, including the local MP Andrew McKay, claimed it was an outrage and should be stopped immediately. The present Broadmoor management, however, allowed the visits by professional actors to continue.
The introduction of electro-convulsive therapy (ECT), otherwise known as electric shock treatment, proved to be highly controversial. Shock treatment in its most primitive form is one of the oldest treatments for the insane: it dates back to the eighteenth century when lunatics were given regular whippings and floggings to jolt them out of their madness. Whether it worked, or whether it was simply good sport for the whippers and the watchers, is impossible to know, but it was a popular attraction, and ‘people used to flock to a place called Bedlam to watch the spectacle’. Therein, of course, lies the origin of the expression ‘to create bedlam’. Eventually, of course, this kind of treatment was seen for what it really was, primitive and barbaric, and sedative drugs have been improved and developed. But the use of electric shock as a treatment for insanity has been widespread and it is still used today in a number of prisons and mental hospitals. The treatment is supposedly quite humane, though some patients do not agree.
Certainly, ECT hasn’t always been humane. Ralph Partridge witnessed a patient at the hospital receiving ECT some forty years ago. His description of it is quite chilling - and he was writing from a pro-Broadmoor viewpoint:
The patient was lying on the floor of a corridor of Block One on a mattress in his pyjamas, covered with a blanket. The ECT is portable and can be used anywhere in the institution where there is a power plug.
He was a powerful man of about thirty-five with a rugged face and one of those twisted expressions commonly met in the Back Blocks. He held out his hand to the doctor and insisted on greeting me, too, with a cordial handshake.
He showed no agitation whatsoever. The ECT was already in place behind the man’s head - a small instrument not larger than a portable wireless.
The doctor plugged the cable in and turned a knob, when a needle on a dial began to turn. ‘One needn’t understand the electrical part of it,’ -said the doctor, ‘but the correct dose for this man is when the needle registers 25 on the gauge.’ A plastic loop, in the shape of a telephonist’s headphone, was then passed under the patient’s neck, bringing two wads of lint in a tight fit against his temples on either side. The electric current is to pass from one wad of lint to the other across his forehead and the lint is wetted with a salt solution to ensure a good contact. A thin cylinder of rubber wrapped in lint was put across his mouth like a bit, for him to clench with his teeth. The doctor had explained briefly to me beforehand what was going to happen: the actual shock would last the merest fraction of a second and the man would never be conscious of it but would go straight off into a chara
cteristic epileptic fit. Two male nurses were kneeling beside him, one with hands on his shoulders, the other on his legs.
I half expected some sound from the machine as the shock was given, but it is quite silent and the only sign of it is the abrupt change in the man. The face is contorted, the eyeB roll up until they almost disappear, an arm begins to swing across the chest with a jerky, automatic motion; the knees rise and fall spasmodically. The male nurses control these bodily exertions firmly and gently, while the doctor holds the chin up with his right hand to prevent any chance of the mouth opening, when he might dislocate his lower jaw or bite his tongue. The doctor, who has given over a thousand ECTs without mishap, draws my attention to the colour of the man’s face, which is turning blue, because he has stopped breathing and his oxygen is exhausted. This is normal and gives no cause for alarm. In case of need an oxygen cylinder is standing within easy reach.
The paroxysm lasts for some two minutes; and then the eyes roll down, the limbs become quiescent and the bluish tinge leaves the face as the man starts to breathe again. A slight froth appears over the roll in his mouth, as he puffs out after each breath.
‘In a moment he will start trying to sit up in a confused state, as he recovers consciousness,’ predicts the doctor.
And so he does. With eyes open, but unfocused, the patient in a dazed way heaves himself into a sitting position and then gently sinks back again, while the nurses adjust the blanket over him. The ECT is over and the whole process has lasted ten minutes.
‘This man will probably stay awake,’ says the doctor, ‘but in cases of depression the patients generally go off to sleep.’ Schizophrenics and epileptics are not regarded as the most likely to benefit from shock treatment. It is for the depressed phase of manic-depressive insanity that ECT is specially recommended: the thread of morbid imagin¬ation is broken by shock and it is hoped the patient may return to consciousness afterwards, almost literally a ‘new’ man. Before ECT little could be done for such depressed caBes, who tended to sink lower and lower in the grip of their despondency until completely demented …
There is no accounting for the consequences of ECT. Doctors go on using it with confidence, not because they understand its electrical influence on the human brain, but because in a flash and without any further argument it can persuade a man to stop shredding his jacket or to eat up his porridge.
In other cases, ECT hasn’t gone so well: patients’ bodies have jumped in the air with the shock, and limbs have been broken. There was also a sad case, in 1991, of a mental hospital patient at a hospital in Dorset who committed suicide because, his wife told an inquest, he could not stand the prospect of further treatment by ECT.
As already mentioned, Dr Hopwood introduced electric shock treatment to Broadmoor and it continued after he left the hospital in 1952. Since then there have been a number of superintendents or general managers and, because of the use of ECT and the increasing use of sedative drugs, few of them have been the subject of attacks. One, however, was held hostage by a patient called Mick Peterson, who did so much damage to the roof of Somerset House that the patients had to be evacuated from the block for some weeks while the workmen moved in to repair it.
There have been, and continue to be, a number of attacks on nurses. A patient named John Silvers spent the best part of fourteen years in the punishment block because he kept punching nurses on the chin and another, Mike Smithers, attempted to bite off a nurse’s ear. A nurse complained recently about the number of times he has been attacked: ‘The bastards always go for my knees, and if it happens much more they’re going to cripple me.’
Ralph Partridge described the buildings at Broadmoor well but if he were able to come back to the hospital now he would be amazed by the new buildings but also to find that many of the old buildings which he described are still standing and in use. The old buildings are grim. Each stands on three storeys with a single staircase connecting the three floors. On each floor a broad passage covered with linoleum runs the whole length of the block. The patients’ rooms are along these corridors, small rooms with bars at the windows. There is just enough room for a bed, a small table and a chair. Each floor has its own communal washroom, and several sets of locked gates so that patients can be isolated if trouble breaks out. The entrance floor to each of the seven blocks is double-locked, even during the daytime, with two separate keys, quite a contrast to the new blocks.
The so-called Back Blocks, with no view of the gardens, are the really desolate ones. They are where the so-called ‘bad cases’ are kept. On the ground floor are the old patients in the last stages before death. You will see them, often wrapped in blankets, just sitting and staring through the windows. For them there is no hope, and death, when it comes, will be a blessing.
On the first and second floors are the dangerous cases. Few, if any, ‘outsiders’ are ever allowed to see inside these wards, which smell strongly of human excreta. Some of the patients refuse to eat and have to be tube-fed. Others are in such a state of hopelessness that they become limp, rather like rag dolls. The great dancer Nijinsky is said to have spent years like that locked away in an asylum. Those who suffer from epilepsy are kept well away from the windows in case they break the glass and try to use it to slash themselves. The chamber pots are made of rubber for the same reason. All of these blocks have their own private airing courts for exercise.
The Solitary Block, for patients in solitary confinement, also has its own airing court, a semi-circular open space, surrounded by a high wall. It is completely bare except for a wooden bench with its legs firmly set in concrete, and there is graffiti on the walls. You get some sad cases in the Special Blocks, people who think they are royalty and suchlike. One man believed the rest of the world was three days behind him. He wouldn’t read news¬papers because he thought they were three days out of date. There’s also what they call the ‘Broadmoor noise’: the endless constant chanting of patients who are unhappy, who believe they have grievances and grudges which no one will listen to.
Five of the seven blocks - or houses as they are called - date back to the original hospital. They have been adapted and improved since those archaic times, but if any patients of 1863 were able to come back now, they would still be able to recognize the place they knew. A terrible indictment on society and the many governments who’ve been in power in the past 130 years.
Change is beginning slowly to happen. Now there are two new ward blocks: Oxford House, which comprises Abingdon, Banbury, Woodstock and Henley Wards in a total of ninety rooms, and Bedford House, which has twenty-five rooms, a medical centre and an infirmary. That’s a maximum of 125 patients and when you think that in January 1991 there were 497 patients here (387 male, 110 female), that still leaves an awful lot of them housed in the old buildings.
The new development at Broadmoor also includes a main kitchen and domestic services building, offices for staff and a refurbished shop which is run by the hospital’s League of Friends. There is also a gymnasium, which Sir Jimmy Savile opened in 1991 after helping to raise the money to pay for it.
Jimmy Savile is a remarkable man who is a voluntary helper at Broadmoor. He doesn’t pay lip service to the job either. He’s here a lot listening to patients’ problems and joining them in various activities. He’s very well thought of by the patients and staff because of his cheerful manner and because he does a lot of fund-raising for the hospital. Occasionally he says some out¬rageous things - he once told the press, ‘All of the people here aren’t bad, but they are all mad!’ - but we forgive him for the occasional indiscretion.
More new buildings are planned at Broadmoor although, for the time being, the money has run out. But, when money is available, one of the old blocks, Kent House, will be refurbished so that the seventy-five patients in there can have their own toilet facilities.
Therapy and rehabilitation are improving, too, and we now have a Director of Rehabilitation. The treatment now available includes chemotherapy, psychotherapy and, they sa
y, more sophisticated medication. You still hear accusations, though, that the nursing staff are a bit too free and easy with drugs to keep some of the patients under control.
In March 1991 the Princess of Wales came to visit Broad¬moor at her own request. This caused a lot of excitement within the hospital. She did a great service in coming because it drew the right kind of media attention to the hospital for a change. It is important that the public are made aware of what happens here, important they know that the inmates are human beings who need help.
Broadmoor publishes its own magazine every month, which is written and edited by the patients themselves. The Broadmoor Chronicle has been produced since 1944 and while it is censored by the management - articles are not permitted to be over-critical of the hospital and the treatment carried out - the writers are still given plenty of freedom. It contains a lot of humour, including jokes and cartoons, and poetry, because many patients find that writing poetry is helpful therapy.
Broadmoor is a self-contained place and the patients make of their lives the best they can. Ralph Partridge wrote of Broadmoor, ‘My opinion is that it is a place for any nation to be proud of.’ That statement is open to conjecture, and it is likely that fifty years from now, Broadmoor will probably not exist in its present form. The way forward has to be in much smaller, more specialized hospitals. But Partridge also wrote, ‘Possibly we are all closer to Broadmoor than we like to think. In the opinion of a man who has intimate knowledge of more than two thousand murderers, sane and insane: “There is none of us who is not capable of murder under certain circumstances.”’ It is also true that the dividing line between sanity and insanity is narrow. Very narrow indeed. A high percentage of the people who read this book will, one day, suffer from some form of mental illness.