Finding Sanity

by Greg de Moore

  We can imagine John picking up one of the dozens of glass jars of urine and placing it before the light, examining what could be examined—colour, density, turbidity—looking for the secrets sealed within that might reflect the minds of the men for whom he cared. What John did each day, as he lifted these bottles to the sunlight, was the timeless act of the medical investigator.

  John had no laboratory so he started work in his garage in the backyard—not the first or last time something revolutionary in the world of science would miraculously unfold in a garage. The jars accumulated, filling the shelves while he searched for a laboratory. As it turned out, there was one literally less than a hundred metres away over the back fence; an empty pantry in a new ward just built but as yet unoccupied. Jean remembers the day he proudly showed her his find: ‘He helped himself to the pantry of this new ward. He took me over to look at it: “Look, look I have a bench and hot and cold water”, everything he needed. And so it began from there.’

  Everyone called this make-shift laboratory, ‘the shed’. The shed—in the timeless tradition of Australian men—was where John kept the tools of trade for his experiments. To get to the shed from the Cade house was a short stroll: out through the gate in the back fence, past the chook pen with its Australorps and Rhode Island Reds, along the gravel path that John took every day. To the right was the paddock with Betty and Kate, grazing and dozing, as draft horses must—then the path continued to the wire door of ‘the shed’.

  John was just about ready to start his experiments, but he needed one further vital piece of equipment—something cold in which to store and preserve his ever-increasing number of jars of urine.

  In a decision that horrified his wife, but seemed natural to John, he chose to store the bottles of urine in the refrigerator in the kitchen of his house. The Cade fridge, with its creamy, rounded shoulders, was a Frigidaire model—an Australian post-war symbol of middle-class wealth; The Australian Women’s Weekly beamed advertisements displaying the modern fridge’s exceptional capacity to keep fresh and cool home-made jams, butter and beer. The importance of keeping urine chilled seemed to have escaped the magazine editors. None of this impressed Jean, but her protests failed to deter her husband; utility always trumped fashion. Each patient’s urine was decanted into a screw-top bottle, numbered and shelved. Beneath the butter sat the urine of dozens of patients: amber brews drawn from mute and immobile melancholic men; fizzing brews from over-the-top manic men that needed a baker’s dozen of nurses to pin down. Every time anyone from the Cade family opened the Frigidaire door, there, staring at them, were the bodily fluids of several dozen mentally ill men.

  For the two boys, it was perfectly natural to push aside a bottle or two of urine to find the cheese, all done with the casualness of childhood. ‘To us it was all normal. We wouldn’t have known whether everybody else did or didn’t have urine in their fridges at home.’

  John Cade set about storing the urine of mentally ill men in the household fridge with no quiver of doubt, and with a single-mindedness that his wife struggled to accept but finally, resistance whittled away, simply did. And with that, the bottles of urine proliferated to fill whatever chilled cavity remained in this household that ran to a very different tune.

  John, almost comically, had glass jars full of urine multiplying and accumulating. Now what to do with them? Well, he did something we might consider cruel, but was natural to an experimentally minded doctor with a hunch. He had no sophisticated equipment to analyse urine, even if he knew what he was looking for. Crude and simple, with shades of Dr Moreau, he decided to inject the urine he had collected into guinea pigs to see how the urine might affect the animals.

  Sometime in 1946, John obtained guinea pigs from nearby Mont Park asylum and caged them in his newly acquired ‘laboratory’. His second son David still treasures the memory of walking into the pantry and seeing his father with the guinea pigs:

  The guinea pigs were in cages, but we also had some at home. They got through a lot of kitchen scraps. I remember Dad handling one of them on his left arm, and stroking it; they were tame from constant handling. They were good-looking: tan, black and white. My favourite was a tan and brown one.

  Jean adds: ‘We had guinea pigs in the shed. Lots of guinea pigs. As they died we’d get some more. He was good to them. He’d call them darling. And say: “Don’t you mind me doing this” as he injected them.’

  John would draw urine from the stored jars into a syringe. The syringes were not the lightweight plastic jobs of today. They were hefty and industrial in design, constructed of glass and metal. They clanged and scraped when assembled, and when sterilised in pots. He would gently hold and turn over the guinea pigs, and inject the urine into their abdominal cavities. It takes little to imagine him moving assuredly and with celerity from jar of urine to syringe to animal.

  John was looking to see if urine from a manic patient might affect a guinea pig differently to urine from other patients. One by one, regardless of the diagnosis of the patient, the guinea pigs perished. And, practising what he’d done all his professional life, and what any respectable doctor might do, he performed a post-mortem on every animal, looking for a deeper understanding of what caused mental illness.

  As the guinea pigs died, he procured more animals and started afresh. Each evening after work and when he had time during the day, he returned to this pantry and worked alone with his animals.

  John was well aware that what he was doing was remarkably crude. So, at first, he kept quiet about his work, telling only a select few who needed to know. Those in the loop included the head of Victoria’s mental health services, Dr John Catarinich, a family friend of the Cades, who organised payment for all the chemicals John used. Today, no one would consider whipping out, buying dozens of jars, filling them with the urine of patients and then injecting the urine into guinea pigs. It sounds archaic and primitive, and it was an era of experimental crudity that was coming to an end. But somehow his upbringing, his pragmatism and his insatiable curiosity gave rise to this hands-on experimentation; it had been the shaping of a lifetime that led him here.

  Although in these early days, John kept knowledge of his experiments close to his chest, even the most solitary of workers craves some recognition or, at least, someone with whom they can discuss their hopes and anxieties about their work. John’s quest was something he wanted to share with another person, someone who might appreciate his endeavours. He turned to his father.

  John Cade’s father could be unapproachable and cold, more so as he grew older. His time in Gallipoli had left him wounded in the way of so many men: irritable, impatient, and drifting into depression. With an attraction to bombast, some called him a snob, or, if polite, pedantic. Nevertheless, John bundled up his ideas and made a path to his father. But it was always going to be a formidable task.

  When John and Jean arrived at David Cade’s home they typically ended up in the lounge, sitting in armchairs near the fireplace. John, as he’d done as a boy, continued to address his father as ‘sir’. If John anticipated curiosity and warmth, he was to be disappointed; David Cade was not open to his son’s scientific ideas, and grew impatient almost from the start. Fustily attired in a three-piece suit, David Cade Snr was light on humour and bamboozled by the chemistry his son spouted. His father—more at home with a style of medicine closer to the nineteenth century than the mid-twentieth—was relieved when he diverted his son from scientific discussions.

  John’s son David, in recalling these conversations, described his grandfather:

  He’d sit in his armchair with his elbows on the arms of the chair and his fingertips together in front of his face . . . Dad would be standing in front of the fireplace with his back to the mantelpiece and you knew it wouldn’t be long before Grandpa started saying ‘Yes, yes . . . John’ He never gave Dad long to explain his ideas . . . he’d say ‘Look, you know I’m not a scientific man, I’m a classical scholar’ and he’d talk over Dad at times.

 
Jack also recalled that his grandfather chopped the conversations with ‘yes, yes’ and moved on, suggesting either a lack of understanding or interest or both.

  John took the cold indifference of his father poorly and complained bitterly to Jean of his father’s lack of interest: ‘I don’t know why I care . . . Dad’s not interested in anything I do.’

  John returned to injecting, observing and performing post-mortems on the rapidly increasing number of dead guinea pigs. When he returned from his afternoon rounds he made straight for his laboratory. Jean remembers how intense, how frustrated her husband became at this time: ‘He didn’t tell me. He didn’t tell anyone of us what he was doing. He wanted to work all by himself. He wanted no interruptions at all.’

  His isolation in his shed, in some ways, was a benefit, and gave him great latitude to trust his instincts and pursue any and every unexpected finding to his satisfaction. Jean said of him that he was sometimes a dreamer and ‘liked to follow his own thoughts through and branch off on to other things’ without hindrance.

  This was a time of intense concentration and longing for John, driven as he was to find some meaning in the experiments he was conducting. With uncompromising single-mindedness, he ransacked his mind for ideas and kept fiddling with combinations and injecting guinea pigs.

  This bleak period of sustained experimental work presaged something much darker in the final days of winter—something John could not have foreseen.

  When John returned from war, like many men, he reflected on the time lost. He felt an urgency to make up for this vacuum. Jean explained: ‘When he returned John wanted more children, feeling he’d missed out on the first two boys.’ John was keen to start, and felt the press of time.

  Jean gave birth to a baby girl, Mary, on 25 August 1946. She lived only 24 hours. The pregnancy had been smooth, as far as pregnancies go, and Mary was full term: a normal child was expected. At least this is how Jean remembers it. The family memory is that Mary was squeezed empty of blood by her mother’s abnormally contracting womb, accidentally and tragically, and was born white and floppy. The death certificate indicates that the cause of death was ‘erythroblastosis foetalis’, an incompatability between the mother’s blood and the baby’s blood, leading to anaemia. As was the custom of the time, Jean Cade was forbidden to see her dead daughter, but over 50 years later wistfully remembered: ‘I was just told she looked like a little angel.’

  It was left to John to organise Mary’s funeral.

  The two boys didn’t go to their sister’s funeral at nearby Heidelberg Cemetery, ‘but we heard from our uncle that it was a tiny funeral and that Dad carried the coffin in one hand’. John once wrote that carrying his dead daughter, in her small white coffin, was the saddest moment of his life. He never spoke about Mary to his boys or about their shared loss.

  John rarely displayed unrestrained emotions in public; men of the time behaved this way. But Changi had also seen to it that when a swell of emotion threatened his equilibrium, such emotion was clipped hard. Nothing wasteful, even emotion, was allowed. Some who met him for the first time after the war recall a self-contained and slightly remote man.

  After the funeral John returned to his experiments. He stepped back into a private world: a pantry filled with guinea pigs, syringes and a wealth of urine. In here, he need not dwell upon the death of his daughter, or at least, he might try to submerge what grief and bitterness he felt, so that those around him could only see what they’d always seen: the undemonstrative Dr Cade, who did what he had to do.

  13

  Suburban Bundoora is not what it used to be. If you are looking for a sense of place or a sense of history on the old hospital grounds where John worked, you might struggle. Above the line of eucalypts, a KFC sign, brash and plastic, is visible; it is hard to re-imagine the world of the late 1940s with such a gaudy neon emblem intruding.

  Bundoora Mental Hospital no longer exists. Dismantled in 1993, only a few remnant buildings, like members of a near-extinct species, have managed to hold out. John’s ‘shed’ is gone; Jack Cade, the oldest son, can still point to where it stood. We know this for sure because Jack took a series of photographs in 1980, in an effort to save the shed as a heritage site. In one photo the shed is framed at the top by a large overarching bough of a massive gum tree. Today, the tree’s girth has expanded a little but its distinctive arching shape and signature markings are identifiable. When we stand next to this tree, we stand before the shed as it was in 1946. The gum tree remains as a silent historical witness to John’s work.

  The photos also take us inside the shed, which is immediately recognisable to Jack—unchanged from the 1940s. Cupboards line the floor on one side of the room; above them a bench and a sink, where John conducted his guinea pig experiments. Above the sink are heavy timbered sash windows.

  We walk towards where the Cade family house stood—that’s gone as well. Jack points out another two gum trees that stood just outside the back fence of their house. The trees mark the direction in which John struck out each day from home to the wards. Today, in the absence of so much that was man-made, the markers that tell us the most are the eucalypts that peg where house and wards once stood. John Cade would have liked that.

  In 1946 John was a man in a hurry. Later in life he wrote: ‘I returned from three and a half years as a POW of the Japanese mourning the wasted years and determined to pursue the ideas that had germinated in that interminable time.’

  These few lines suggest that Changi had been a kind of crucible for John, in which to think about his notions of mental illness. Unhelpfully, though, John never expanded on what ideas did take root during his time as a POW, but clearly something creative strained within him.

  John was a self-described ‘lone wolf’ researcher who preferred to labour on his own. He did not seek out a mentor to foster those tingles of imaginative thought or, until years later, supervise research students. And he was no chemist, but he had knowledge gleaned from Changi and, as part of his work at Bundoora, he routinely prepared prescription medications for his patients, often from the basic chemicals.

  John pursued a number of leads over the next eighteen months. His early experiments suggested to him that the urine from manic patients was more toxic than urine from other patients, and therefore killed more guinea pigs. As it turns out, John’s belief that manic urine was more toxic was false—urine from a manic patient is no more likely to kill a guinea pig than any other sort of urine. This mistake, like countless others that scientists have made over the centuries, was a fortunate one, as it spurred him on, and he continued unhindered with his idiosyncratic research.

  John’s mind bubbled in anticipation of finding something in the urine of manic patients. What could it be? There are two known toxic substances in urine—urea and uric acid. Both are breakdown products, halfway houses of the body’s metabolism. Perhaps one of them was the elusive chemical toxin he was after.

  Some of John’s chemical experiments make for intriguing reading. Left for posterity, they resemble the scribbles one might find in a high school chemistry notebook. At one point he adds 3 cubic centimetres of hydrochloric acid to every 100 cubic centimetres of urine to get a precipitate and then he takes us through the steps of filtering; there is more than a whiff of a home economics class when John writes that he adds ‘one level teaspoon’ of charcoal for every 100 cc. And then, when he reminds himself to ‘shake for 5–10 minutes’, he appears in our minds, absurdly, behind a cocktail bar as if preparing an evening gin and tonic.

  When finally done, John hit upon the idea that urea was the toxic element in all the urines that killed the guinea pigs. The conclusion he drew was that there was more urea in manic urine than in the urine of patients with other mental conditions. But when he tested this idea he found that manic urine had no more urea than any other urine. He was stuck.

  To get over this setback he postulated that urea and uric acid might work in tandem to make the urine of manic patients more toxic.


  He started to work on uric acid, and this is where his experiments grew fascinating. To make up different strengths of uric acid he needed to convert it into a substance that he could more easily manipulate. On its own, uric acid would not dissolve in water. To persuade it to do so, John added the element lithium to uric acid to make up a compound called lithium urate. And that is where lithium comes onto the scene, en passant, almost apologetically.

  In the course of trying different combinations, as any good scientist might, John then injected lithium alone, as lithium carbonate solution. That’s when he drew breath, and promptly forgot everything else, except for lithium.

  When John injected the lithium, the guinea pigs seemed restful. In one memorable description he said that he simply lifted one of the guinea pigs, turned it over, and placed it gently on its back. Instead of doing what any respectable guinea pig should do when placed in such a vulnerable position—turn over and stand up in protest—this guinea pig simply lay on its back and looked vacantly at John. He repeated this experiment again, and the response was the same.

  Behind John’s unfathomable face something stirred, a shaft of comprehension.

  Uncharacteristically agitated, he summoned his wife, a day she remembered. ‘He called me from the kitchen, with great excitement, to come and see.’ And John showed Jean how, without any difficulty, he could turn a guinea pig over on to its back and move it around without any protest. These lovable rodents, normally a mass of vibrating muscle and fur, now with lithium in their bellies, would lie with equanimity on their backs, staring with soft eyes at John while he gently prodded them with the stub of his index finger. He had never seen them behave like this. They seemed alert, but they were calm.

  So what was going on here? John thought that the lithium was calming the rodents. Looking back, it is more likely that the guinea pigs were ill, due to the toxic effects of an excessive dose of lithium. But John didn’t know this. What he saw was a rodent stilled by lithium.