by A. J. Lees
11
– The Junk Vaccine –
After we had been using apomorphine for about a year, I was contacted by Ann Langford Dent, the daughter of John Yerbury Dent, the physician who had treated William Burroughs in London for narcotic addiction. She, along with her elder sister, Jane Yerbury Sweeney, had continued to hold a torch for their father’s treatment methods and hoped that I could join their lifelong campaign to encourage psychiatrists to re-evaluate apomorphine’s efficacy as a healthier more effective alternative to methadone. In one of her distinctive handwritten letters distinguished by her large attractive script and headed with an eye-catching ink drawing of the human herd on the Kings Road, Ann wrote:
Grandchild No.6 aged four months and a commission to paint a mural 10 feet by 10 feet keep me busy, but as I can see the light at the end of the tunnel my crowning satisfaction would be to see Apomorphine used to cure alcoholics and drug addicts.
In the spring of 1956, William Burroughs had travelled from the native quarter of Tangier to England. His dependence on synthetic opioids had become so absolute that he had not removed his clothes for almost a year except to stick a needle into his fibrous, sallow skin:
I am not an addict I am the addict. The addict I invented to keep this show on the junk road. I am all the addicts and all the junk in the world. I am junk and I am hooked for ever.
– The Beginning is also the End
His distraught parents had paid for his flight to England and arranged for a referral to a Dr MacClay in Queens Gate Place. MacClay did not see Burroughs but referred him directly to his Kensington colleague, Dr Dent, a practitioner who had gained a reputation for the treatment of chronic anxiety and alcohol dependence. Dent had summarised his views in a best-selling book entitled Anxiety and its Treatment with Special Reference to Alcoholism (1941), in which he provided convincing and measured arguments that the chronically anxious were at particular risk of developing serious addictions. Despite his distaste for public office and complete absence of political nous, he had also served dutifully as the Secretary of The Society for the Study of Addiction from 1944 to 1947.
After qualification at Kings College Hospital in London, Dent worked for five years at the St Pancras South Infirmary, where he had learned to use apomorphine injections to sober up stuporous drunks brought in by the police. In an oral presentation delivered before The Society for the Study of Addiction in 1948, he recanted his earlier view that apomorphine was an aversion therapy. Based on his extensive experience in more than two hundred and fifty alcoholics he told the Society’s members that apomorphine worked through a specific ‘metabolic’ action on the ‘sleep centre’ in the hindbrain. Morphine and alcohol inhibited the forebrain whereas apomorphine stimulated the back brain and particularly the almond-sized hypothalamus.
Dent was a contradictory character, gracious yet brusque, argumentative, shy yet noisy but smart enough to know that shit happens on a daily basis in medicine without any help from arrogance, vanity or incompetence. One acquaintance likened him to an intellectual Brigadier-General. He was fortunate to practice in an intrepid era where doctors were allowed to treat patients based on their own conscience and openly challenge dogma without risk of being struck off the medical register. Dent enjoyed his autonomy and was free to prescribe what he liked. He didn’t need guidelines from so-called experts but based his decision making on his experience and knowledge. Although he was an atheist, the Quaker principles of his family – simplicity, pacifism, integrity, community and equality (SPICE) defined his medical ethics. His practice was run on Robin Hood lines; the rich were expected to pay more to subsidise his poorer patients. In a post-war world of back street abortion, gay sex crime and the continuing shame of intemperance, he was one of the few who had the courage to treat the forsaken and disheartened. He was also a consultant at St Mary’s Ursuline Convent in Surrey where the nuns took in women addicts and treated them with great success under Dent’s guidance.
A few months before Burroughs arrived on his doorstep, Dent had written an editorial in the October 1955 edition of the British Journal of Addiction (Alcohol and Other Drugs) condemning the British Government’s recent decision to stop the legal production of heroin in the UK. He warned that a flourishing black market in narcotics was now inevitable and despaired that the State was even more ignorant than the medical profession about the mechanisms of addiction. A few months earlier he had also written to the Journal of the American Medical Association regretting the lack of enthusiasm for apomorphine in the United States. He believed that maintenance treatment was trading one addiction for another and conforming to an economic imperative. Hundreds of deaths were occurring every year from methadone overdose. It was the perfect capitalist scam.
34 Addison Road was a large comfortable house separated from the road by a stuccoed stone wall with a kennel at the front for Dent’s Scottish terrier. The first floor had been modified to accommodate his surgery and a small receptionist’s office and had a fine view onto a pretty but unkempt English garden with a fishpond and a random sprinkling of creepers and shrubs.
Burroughs, dressed in a sombre grey suit, rang the doorbell and waited nervously with hat in hand, fearing the doctor might turn him over to ‘the heat’. Dent opened the door in his braces, a stocky short man with shaggy white hair and a moustache. Over a cup of tea in front of a blazing fire, he tried to relax his new patient with a few light-hearted asides. Burroughs told Dent that from the age of thirty he had seldom been sober although he had not always been addicted to drugs, that he had taken ten cures and after every one he had lapsed at the first opportunity. An episode of delirium in Tangier had freaked him out and made him realise that if he didn’t come off dope immediately he would soon be dead. To his surprise, Dent then asked him if he would feel more comfortable if he had an injection of morphine, to which Burroughs replied, ‘Well that would help.’
Burroughs went on to tell Dent that before leaving Tangier he had been hitting with methadone every hour, using up to 15 grains a day. At this point Dent got up to feed his tropical fish. By the time the doctor sat down again he had come to the conclusion that Burroughs was a hard-boiled American who genuinely wanted to quit narcotics but would not be taken in by any form of pompous medical bullshit. Dent explained that he was not a moralist but a chemist and that chronic opiate use had caused a metabolic dysregulation in Burroughs’ brainstem. Although apomorphine treatment should be continued for no longer than ten days, remission could not be considered to have occurred until a month after that. He also warned him that the treatment could be unpleasant, particularly during the first two days. Sixty per cent of the patients he had treated with apomorphine had managed to remain off alcohol or drugs.
He also informed Burroughs that according to the Home Office there were only 306 people addicted in Britain to opium, heroin, morphine and Indian hemp. Just under half of these were women and over half of the male addicts were physicians. As Burroughs got up to leave, Dent informed him that he wanted him to switch from methadone to morphine prior to apomorphine, to which Burroughs replied, ‘Magnificent man.’
Burroughs was admitted to 99 Cromwell Road, a four-storey building that also housed an abortion clinic. He had his own room with rose-coloured wallpaper and round-the-clock personal nursing care from Sister Morse and Sister Gibson, Dent’s two nurses. Apomorphine was injected in a dose of one twentieth of a grain every two hours day and night, gradually increasing the interval between injections. He was advised to remain in bed and was prescribed Vitamin B supplements and was also allowed to take diminishing quantities of morphine over the first three days. On one occasion, Dent arrived unannounced at two in the morning and stayed talking to the wide-awake Burroughs until dawn. Dent knew that addiction had a huge psychological dimension and that any method used to convince a patient into adapting to a differing strategy for life needed to be holistic. Burroughs experienced far fewer withdrawal symptoms with apomorphine than with any of the other detoxification t
reatment approaches he had tried. He slept very little but the slow, painful, constricting feeling of death that he had come to associate with opiate withdrawal was absent.
On discharge from the clinic he was given some tubes of apomorphine pellets to use in the event of delayed withdrawal symptoms and instructed to stay at his lodgings at 44 Egerton Gardens for the next seven days. Dent visited him there and re-emphasised to his patient that he would need to reach a state of mind in the ensuing months where he no longer wanted narcotics. He pointed out that apomorphine was an effective treatment but the onus of travelling beyond a tomorrow free of pain and junk lay firmly on Burroughs’ shoulders. Dent used his considerable motivating powers to encourage his patient to stick at writing as a form of therapy and also recommended that he follow up with some complementary therapy including an abdominal exercise system. In Dent’s view there was no such thing as willpower when it came to addiction.
Burroughs’ attitude to doctors was ambiguous. He equated the paternalism of the doctor-patient relationship with the dependency of the addict on his pusher. Medical practitioners were the opium of the people. Many ‘croakers’ as he referred to doctors, were greedy, corrupt and ineffectual and some exerted damaging nocebo effects on their trusting patients. His creation of the amoral Benway was his revenge for the corruption that he felt defined doctoring. Burroughs was medicine’s nemesis and a living Doctor Benway. At the same time he longed for a physician who could help him obliterate his ruminant viral fears and become a trusted ally.
Burroughs described Dr Dent as the least paranoid of men, and a physician who possessed ‘the full warmth and goodwill the English were able to offer’. He was the nearest thing Burroughs ever had to a Dr Watson. Their ideas were uncannily similar, and their relationship more like father and son than doctor and patient. When the two had first met, both were at the end of the line. Burroughs was addicted to drugs and unable to write, Dent was dying of consumption and had been denigrated by his profession as a maverick. Both men were iconoclasts who held a distaste for globalisation and consumerism and shared an affection for cats.
They exchanged stories and discussed subjects of mutual interest. Burroughs warmed to his doctor’s loud laugh and confident professional approach. Dent reinforced to Burroughs that he had great potential as a writer. By today’s standards his stewardship of Burroughs might have been censured by the General Medical Council but at that time the profession was more preoccupied with breaches of confidentiality and the misdemeanour of advertising than curbing the freedoms of the doctor-patient dynamic. Dent was not the only one promoting the use of apomorphine. There were similar champions in France, Switzerland and Denmark, all reporting good results in private practice.
In a letter to Allen Ginsberg on May 8 1956, Burroughs described his experience with ‘Dent’s cure’ as unpleasant but nowhere near as bad as some of his previous detox experiences and that he was now determined to make it. He also commented on the pleasantly relaxing effect of apomorphine. In a second letter posted a week later he stated that he was now fully recovered, no longer dwelling on his previous way of life and that he was able to drink alcohol again. He hated the grim greyness (‘London drags like an anchor’) and headed back to Tangier from where he wrote yet again to Ginsberg informing him that he had completely lost all desire for narcotics and sex.
Encouraged by Dent, Burroughs wrote ‘Letter from a Master Addict to Dangerous Drugs’, which would be published in The British Journal of Addiction (Volume 53, issue no 2, 1957). In this article, written for medical practitioners, Burroughs stated he had become an addict because he did not have strong motivations in any other direction. He was bored and disillusioned after Harvard and didn’t know what to do with his life. He had first taken junk out of curiosity. He had then drifted through life taking shots whenever he could score, attracted by the outlaw lifestyle and the glamour of gangsterhood. He had never wanted to be an addict but one day he woke up feeling sick and realised he was hooked. He went on to say that apomorphine was by far the best method of treating withdrawal he had experienced in that it reduced the symptoms to an endurable level and led to a more rapid recovery than any reduction cure. Apomorphine had abolished the craving and almost certainly saved his life. In Burroughs’ words, saying an addict had been cured by methadone was like saying an alcoholic had been cured of whisky by the use of gin.
This watered-down article pigeonholed him as a biased addict whose evidence could not be relied upon and was greeted with disdain by Dent’s medical opponents.
Despite Burroughs’ claim that ‘the junk vaccine’ could evict the addict personality, it was not a permanent cure for his habit. In the first few years after his ‘cure’ he relapsed twice on a French compound containing opium called Eubispasme Codethyline and needed further visits to Dent and courses of apomorphine pellets to get himself straightened out. For several years he carried a supply of apomorphine with him wherever he went as a preventative.
On 27 July 1960, Burroughs wrote to Dent from The Empress Hotel, 25 Lillie Road, London:
Dear Doctor Dent
I don’t know if Harry Phipps told you about my intention to write an article on a popular level concerning the apomorphine treatment of all addictions. I hope you will give me permission to quote from your book …
– Rub Out the Words: Letters 1959–1974
A year later Dent wrote to Burroughs:
Dear Burroughs,
Thank you very much for the Naked Lunch which arrived safely. I congratulate you on it. I do sympathise with you on your country’s idiocy in its attitude to apomorphine we shall win in the end …
Yours as ever
J. Dent
On January 16 1962, Rhoda Brennan, a close friend who had lived with her husband and Dent at Addison Road, wrote to Burroughs from 160 Holland Park Avenue, London:
Dear Mr Burroughs
I know you will be sad to hear that John Dent died very suddenly on Jan 8th. It was a coronary thrombosis and he died as he would have liked sitting in his chair in the dining room playing patience …
He was so fond of you and interested in your work. I wish there was any one like him to carry on his work but I’m afraid there isn’t.
Yours sincerely
Rhoda Brennan
For Dent, apomorphine was always work in progress and after his death William Burroughs became his standard bearer, railing against the US Narcotics Bureau, and the American Medical Association’s refusal to condone the treatment. In Burroughs’ opinion addicts should never be asked the question ‘Why did you start using narcotics in the first place?’ It was as irrelevant as asking a man with blackwater fever why he had travelled to a malarial infested region. He felt that reliving the addict experience as a form of therapy was positively dangerous and that psychoanalysis should be contra-indicated.
In a panel debate organised by Playboy magazine in New York in 1970, which included the veteran Commissioner of the Bureau of Narcotics, Harry J. Anslinger, and John Finlator, Director of the Food and Drug Administration’s Bureau of Drug Abuse Control, Burroughs was asked his views on how the problem of heroin addiction could be controlled:
Apomorphine is listed in the United States as a narcotic subject to the same regulations as morphine but in both France and England only an ordinary prescription is required and it can be refilled any number of times. Its difficult to avoid the conclusion that a deliberate attempt has been made in the United States to mislead medical opinion and minimize the value of this treatment.
Throughout the second half of the twentieth century the use of heroin in the United Kingdom slowly increased and became a degrading lonely lifestyle choice for large numbers of young men. People no longer became addicts by chance as perhaps they had in Burroughs’ day. In the deprived inner cities ‘trainspotting’ and ‘dragon chasing’ was a salient part of life for increasing numbers of clueless losers with time on their hands.
By the eighties, scientific evidence had accrued in support of
Dent’s views but ironically apomorphine’s use had slowly fizzled out. Burroughs was finding it increasingly difficult to recommend physicians who were prepared to provide apomorphine for his many addicted correspondents. Mrs Smith (‘Smitty’), one of Dent’s old nurses now living over a pub in Devon, was still giving apomorphine and had treated Keith Richards in his Cheyne Walk apartment. In his autobiography, the Rolling Stone guitarist described ‘Smitty’ as vicious and authoritarian, and apomorphine as aversive – the worst torture he had ever experienced. Perhaps the molecule’s great antiquity with its chequered history as a sedative, expectorant and emetic had something to do with it. Its name had also counted against it with the public.
In July 1983, Burroughs wrote to Isabelle Aubert-Baudron, curator of the Interzone, a web-based French publishing house, expressing his frustration over the attitude of doctors and the imminent demise of apomorphine:
Doctors are, by and large drastically limited in outlook. They have read all there is to know on any subject and that is that. Anything outside their knowledge cannot be worth hearing about. So I really gave up years ago. Some doctors in Denmark still use the apo treatment but they clash with the psychiatrists. In my opinion a substantial number of psychiatrists should be broken down to veterinarians but that goes for the medical profession in general.