Finding Sanity

by Greg de Moore

  The boys knew the patients well, in that kind of way young boys who live in a world of their own making—partly supervised by parents but largely on the loose—are wont to do. It was a world often real, sometimes make-believe. The vague but undeniable anxiety adults felt when walking on the asylum grounds was never felt by the boys, and in some ways, the world the two Cade boys inhabited gave them an understanding of patients no adult could ever have. ‘We weren’t ever scared of them; only of the snakes, which slithered in the paddocks.’

  To the north of the hospital one could see Mount Macedon and to the southwest, the grey skyline of Melbourne, flat and sluggish. But it was to the other points of the compass that the boys found most joy.

  The paddocks extended to the west of the house a good distance down to the blackberry-lined creek. To the southeast the boys could walk or ride their horses across Plenty Road and into another asylum—Mont Park Mental Hospital. They spent plenty of time at Mont Park, where they played on the narrow train line that brought in coal to power the asylum’s lights and heat its water and ovens, and larked about the Aboriginal canoe tree not far from the superintendent’s house. The farm at Mont Park provided fresh fruit and vegies to Bundoora, and was a target for the boys: ‘Jack and I would raid the orchard. You’d get pears, peaches, apricots and more.’ Each day, a select group of Bundoora patients headed to Mont Park to work in the orchard, then helped transport food and milk back to Bundoora. ‘The patients milked the cows at Mont Park and then they delivered the milk on horse and cart, originally in big billies that were about a metre high.’

  Wide-eyed, the two boys came across individual patients that they remember to this day. Although the minds of the men they encountered overflowed with odd ideas and strangeness, there was a spot, here and there, like an oasis, where their past lives sat unscathed. Some of them were lettered men with the finest of educations; others were blessed with exquisite craft skills. One such man was Harry, a wizard with his hands. The boys took a shine to him. David recalls that, ‘Harry was a genius at making things; he had a shed.’ And it was into this wondrous shed that the boys disappeared, to be shown the magic of dismantling and mantling everything. Harry was their teacher and he could fix anything the boys brought to him.

  Jack also remembers the patient well:

  Harry was an expert fixer of clocks and watches. You’d walk up a couple of timber steps and into, well, it was like an old-fashioned shop, his shed; it had lots of cogwheels. He taught me how to build a crystal set radio. I used to get spare parts from army disposals. I could easily still put together the small radio he taught me to make; I tucked it into an old cigarette box. I could pick up a few of the Melbourne radio stations: 3LO, 3AR, 3DB and I’d listen to the footy on Saturdays.

  Frankie was another favourite of the boys. He’d sit outside the Cade house, in his three-piece suit minus a tie, and move about, cutting a bit of grass here and there. Frankie was a master of the obscure line and repeated endlessly—to no one in particular—one sentence: ‘I’m just going to try and secure my observances.’ Naturally no one had the remotest idea what Frankie was on about, but this lack of understanding seemed not to perturb him or them. Jack recalled some vital instructions Frankie imparted to the boys: ‘He had a little chat with us, to show us how to smoke a cigarette. David and I used to collect butts from around the asylum and then you’d break them open and put them into the bowl of a clay pipe. Appalling stuff.’

  In that respect the asylum was no different to the outside world: nearly everyone smoked. Tobacco, it seemed, was more coveted than discharge from the hospital. Cigarettes, provided by the Red Cross as a ‘comfort’, were rolled with great dexterity. The boys remember the common sight of men with a wad of tobacco in the palm of one hand, using the heel of the other hand to knead the tobacco into shape. Then, in a few seconds, often one-handed, it was rolled, wrapped in paper, licked wet, sealed and you had your cigarette: a slick operation. Then a wax Vesta match would be conjured, struck on a trouser leg and the smoking would start. The soon-soggy tip sat on lips everywhere. In no time a couple of hundred roaming chimney stacks moved about the asylum.

  The best time of all with the patients—and the highlight of the boys’ week—was undoubtedly the weekly Red Cross concert. Nothing was so anticipated, or widened their young eyes or set their pulses pounding as much as this.

  Every Sunday the boys raced up the gravel road outside their house towards the water tower, which stood at the apex of the hill. About halfway up the hill was the wooden hall where the concerts were held. David remembers that he and Jack were always smartly clad (something their mother insisted upon), wearing polished black shoes, long socks and short pants. At the hall’s entrance the two boys milled about with the hundred or so patients lathering about them, all edging forward to get the best seats.

  At the entrance were posters advertising upcoming movies, ‘usually a Western that had finished its run in town’. When the door was flung open, Jack and David dashed to their favourite spot—the front row—followed by scores of patients, filling the hall to the brim within minutes.

  The hall was typical of its time, and remains a bit of blur to the boys: there were timber floors, and individual wooden chairs were set in rows, with benches at the back. At the front, the stage rose to their shoulders and on it was an upright piano.

  The afternoon always started with the playing of ‘God Save the King’, and all stood, erect and respectful. It is interesting to observe how even the most disturbed psychiatric patient, when placed in a social situation where a certain behaviour is expected can, momentarily, conform to the task. How some manic patients stilled themselves sufficiently, or the occasional depressed patients found the vitality to rise from their chairs, remains a mystery.

  The Sunday concert could include a movie or a magician or a musician, and sometimes a puppet show. David remembers how the audience responded:

  The patients would roar their approval and stamp their feet. Punch and Judy was a highlight for us. The patients loved it. The patients all loved the songs and they all joined in, many of the patients played music themselves, most of them seemed to be able to whistle a tune; commonly patients played a mouth organ, a small one, often kept in their pocket, or they played a kazoo around the grounds, or played a comb; they always had a comb in their pockets, usually their top outside jacket pocket; and would wrap a piece of tissue paper around the comb and put it against their mouth and play.

  Someone would sing on stage, usually with a piano accordion. Lots of Irish songs, Jack and I would remember the words to this day to the songs because they sang the same ones so often: ‘When Irish eyes are smiling’, ‘Molly Malone’, ‘On the Road to Gundagai’ and ‘Botany Bay’, ‘Click Go the Shears’ and all the war songs. Vera Lynn was a favourite: ‘White Cliffs of Dover’, ‘We’ll Meet Again’. All the men would sing and roar approval.

  The men stomped their boots hard upon the reverberating timbers and roared and laughed and sang for the afternoon, the same songs each week. Some were songs of remembrance; some were anthems of defiance—directed towards a hated wartime enemy. The ‘Colonel Bogey March’ was the classic whistling song for the patients and they’d sit upright and whistle this again and again.

  At the concert’s conclusion, the door opened, letting a narrow shaft of light into the dark interior. The two boys and the hundred or so patients flowed out through this slit in the wall, a thin stream pouring down the hill—a few patients still marching in time and whistling ‘Colonel Bogey’ all the way back to their wards.

  Virtually all the patients, it seemed to the boys, owned a pocket knife and whittled away on pine bark; pine trees were plentiful on the grounds. Like sailors working on whale bone on long sea-voyages, the patients worked on what was at hand, and it seems as if the pocket knives were of no concern to the medical and nursing staff; certainly the boys never felt alarmed. In their exceptionally generous way, the men gave presents to the boys, one being beautiful carved wood
en boats: ‘They carved the bark; the toy boats were magnificent,’ says David. ‘Jack and I had one, mine was called the “Lady Harriet”, and the masts were almost a metre high with full rigging; it was beautifully carved and would actually sail.’

  The patients also taught the boys how to set rabbit traps. These heavy metallic traps had huge claws, with interlocking teeth, like some lurking deep-sea monster. How the patients had access to such lethal instruments the boys cannot recall, but the obvious fact that such an apparatus might be a danger in the hands of a patient seemed of little concern to the boys. They simply saw adventure. The claws of these traps were ‘about the size of our fingers’ and, opened up flat, the traps were buried in loose dirt. ‘The patients showed us how to operate them, and where to put them in the paddocks. They showed us where the rabbit runs were, near the creek.’

  The boys weren’t the only ones interested in hunting rabbits. There were no houses for miles into the distance around the Bundoora Mental Hospital, and the paddocks that stretched westward as far as the boys could see, were stuffed with rabbits. That appealed to the boys and also to their father, for Dr John Cade was a shooter with a sharp eye. ‘Dad had an old Winchester single shot pea rifle, he’d had it since he was a kid.’

  When John returned from the wards, late in the afternoon, without any suggestion of changing from his coat and tie, he would set out from home, gun slung over shoulder, step over the gravel road, slip through the barbed-wire fence and head down to the creek, whose course could be seen from afar, running alongside the spiny thicket of blackberry bushes. The boys would follow eagerly.

  When the trio of hunters returned later in the evening, the shooting doctor and his two small boys came back as they’d left, dumping the rifle, bullets and quarry—usually rabbits, but sometimes a hare—in the laundry. John then set to skinning and gutting. He was good at this, and his hands moved fast, precisely. Unruffled, and still in his work clothes, he soon had the stringy meat of a carcass. Sometimes he would wrap the carcass in a hessian bag, to ward off flies, and hang it in the laundry until it ripened, slowly, ready for eating. He loved jugged hare, that somewhat anachronistic gamey English dish. One culinary tradition entailed braising the hare slowly in its own juices and blood, with a touch of red wine and a handful of berries. The stench—blood of hare and gut of rabbit—that drifted from the young doctor’s house must have aroused the curiosity of patients and attendants. But none of that mattered to John. He did what he wanted to do regardless of the enquiring looks of those around him.

  12

  An idea smouldered in John’s broad-gauge mind. It had, even before Changi, but Changi made it glow. It was an idea that came, not from any psychiatric line of thought, but from a study of food and nutrition, and how the smallest of elements affected people’s bodies and minds. And there is evidence, from John’s library, of how that idea came about.

  John Cade was a prodigious reader of books. Fortunately for us, he was of that school of readers who jot their impressions in the margins as they read. Equally fortunately, some of his library remains, with his characteristic, precise notations and his immaculate underlining. In these jottings he has left us clues as to what he did during those critical years from 1946—clues that require some deciphering but they are an aperture into his mind.

  On the inside cover of his books, John, characteristically, wrote his name and date of purchase—we wouldn’t expect anything else from this punctilious man. So we know that in the year he started his classic experiments, 1946, he purchased a book, Recent Advances in Endocrinology—hardly a title to turn heads. The author was a certain A.T. Cameron, a controversial British-born Canadian Professor of Biochemistry, who wrote about the body’s hormones and not really anything much at all about mental health. We might think this unusual reading for a psychiatrist, but it almost certainly reflected John’s view that he was first a physician, and second, a psychiatrist. It was a private joke among colleagues that he rarely went anywhere without a stethoscope stuffed into his coat pocket. John Cade, the doctor, saw the body and brain as a chemical laboratory.

  The first organ discussed by Professor Cameron—the thyroid gland—was of keen interest to John, and he underlined in immaculate blue fountain pen ink all that fascinated him. It set him on a clear path. Cade was intrigued by how the thyroid gland—a butterfly-shaped organ that sits at the front of the neck—could alter behaviour. When it is overactive, the thyroid gland secretes excessive amounts of hormones, powerful substances capable of triggering changes elsewhere in the body. In response, the body rocks in agitation and the mind is flung into restless thought. When, however, the thyroid gland is underactive, less of the hormones are secreted and the body is sluggish and the mind impoverished. It was a model that had a profound impact on the way John thought about one particular psychiatric illness: manic depression.

  John speculated: was it possible that an excess of some unknown chemical orbiting your body made you manic—with all its wild elevation—and, if so, then maybe a deficiency of this same chemical made you depressed? It was a simple notion: excess of something in the body caused mania; deficiency caused depression. It was this slip of an idea that set him on a pathway of discovery.

  Manic-depressive illness had long intrigued John. If anything, it was the black depressions of the illness that moved him the most.

  Jean recalled a remark typical of her husband:

  If you saw some of those melancholics it would break your heart. They just sit in the airing court and don’t do anything. They might just pick their fingernails. If I could just get them out of themselves . . .

  So in 1946, John’s starting point was a belief that mania was caused by an excess of a naturally occurring substance in the body, a type of intoxication if you like. And that depression was the opposite—a deficiency of this naturally occurring substance. Now of course, all this was wild speculation because he certainly had no idea if such a substance existed in the body and, even if it did, he had even less idea of how to find it. Still, this was his launching point.

  John Cade was a pragmatic man. The practical question he had to answer was this: how could he possibly know what was happening inside the manic-depressive brains of the men for whom he cared? There were no modern imaging devices to chart the structure and size of the brain in 1946. Repeated blood tests were intrusive and, anyhow, none were known to point to any specific type of mental disorder. What could John examine in order to find this imagined substance that caused mania in excess? His answer, perhaps surprisingly, was urine.

  Jean remembers the start of her husband’s experiments: ‘He came to me and said: “I’ve got to do some research on why these patients have got different illnesses. I’d like to find the melancholias first. I’ve got an idea that might come to something if I save a lot of jars.’ Why her husband needed jars for this work was not immediately apparent to her, but soon the jars started accumulating.

  John travelled to the city and purchased numerous bulky glass jars from McEwans, a department store in Melbourne. His wife, seeing her house, then garage, bulge with these jars, was less enthusiastic. ‘We had no money, I kept telling him.’ But John, on a determined line of thinking, was oblivious to his wife’s concerns.

  ‘I was horrified, we couldn’t afford it. He just said: “we might be able to use them afterwards for pickles”.’ This, undoubtedly, was a private joke of John’s, for as soon as he had acquired sufficient numbers of jars, John started to fill them with urine from his patients. To examine the urine of his patients might seem bizarre to us but it would not have seemed the least bit odd to John Cade. Doctors had long considered urine to be the portal into a man’s body and mind.

  To the average person, urine is hardly worth more than a passing—if sly and mildly distasteful—look. Whatever anyone else might think of urine, it was about to receive John’s complete attention. It was an examination of urine that led him to a series of experiments that would change the course of medical history.

>   John’s thinking ran like this: if mania was due to an excess of a chemical circulating in the body, then just maybe some of this excess chemical might be expelled in the urine. What he was hoping to find was an excess of this putative chemical in the urine of manic patients. If he could prove this, then, it might set him on a path to find a treatment for mania.

  He hit upon the idea of comparing urine from patients with different illnesses. Did the urine of a manic-depressive man differ from that of a man with schizophrenia, he wondered. John instructed the ward attendants to place a metal container at the foot of each man’s bed. Each morning melancholics, manics and schizophrenics—the tribes of men whose afflictions had rendered the Bundoora asylum their home—were requested, reminded, perhaps cajoled into emptying their bladders into these metal repositories. It was asylum lore that early morning urine was the most potent brew to collect, any chemicals being concentrated overnight. If anything was to be found, it would be found there.

  When it came to the art and science of collecting urine, the nursing staff found all they needed to know in their ‘red bible’, the Handbook for Mental Nurses. They cradled this book, thumbed it and flicked through its pages. It highlighted routine, rigidity and responsibility: the triad of asylum life. And nothing was more written up, measured or indicative of this world of fixed habits than the collection of urine.

  Once collected, each patient’s urine was emptied into one of John’s glass jars. Inquisitive medical minds had for centuries pored over the significance of urine taken from patients with every type of illness—mental or otherwise. The hues of urine, they speculated, might reflect the mood of the patient, and doctors for years had scribbled descriptions of this liquid, like vignerons rapturously hanging words in the air about a vintage year.