Friday 28 April 2017

Spotlight on the Retreat archive: a satirical sketch of the Retreat in the early twentieth century

This is the fourth in a series of blog posts celebrating the Retreat archive and our digitisation project as it nears completion. The Retreat is one of the most important institutions in the care and treatment of mental health patients. Over the last two and half years, staff at the Borthwick have been working through the archive, preparing the documents for digitisation, carrying out conservation treatments where appropriate and photographing each item page by page.

This has been a huge task. Over 600,000 images have been created so far and the focus has been on handling each item with care and capturing a high quality image efficiently and effectively. Of course there have been many items that have caught our eye along the way. In this series of blog posts project staff pick out some of the interesting items that they have encountered.

Here Kath Webb, our resident expert on the Retreat archive introduces ‘Dr. Selfopinion’, ‘Dr. We’llsee’ and the ‘Paying Guest’

One of the delights of sorting and cataloguing any archive is that you never know what you are going to find. One gem, which I discovered just a couple of years ago, consists of a small but perfectly formed satirical sketch of the Retreat, written in June-July 1922 (RET/6/19/1/79).

‘A Mock Trial between a patient and the Medical Officers at one of the best and largest mental institutions in the country’, written by ‘Paying Guest’, is an 11 page typescript. The scene is a London law court, midsummer 1922, and the characters include a judge (‘Mr Justice Longhead’), a counsel for plaintiff (‘Miss Cocksure, KC’), two defendants (‘Dr. Selfopinion’ and ‘Dr. We’llsee’) and the plaintiff (‘Paying Guest’ himself).

RH characters.jpg
List of Characters in ‘A Mock Trial’
It opens thus:

Mock Trial 1.jpg

The sketch focuses on Miss Cocksure’s examination of ‘Dr. Self Opinion’ and then ‘Dr. We’llsee’, who justify their treatment of Paying Guest’, their patient. After their interrogations are complete, the judge declares:

Mock Trial 33.jpg

And he delivers his sentence:

I pronounce sentence on each of them, namely – To be imprisoned with hard labour, for life. They must also pay all the claims made upon them by the Plaintiff, so far as their bankers will allow them still to overdraw their accounts with them.

The sketch ends with the court being cleared ‘with much fighting amongst the blackguards’ and orders relating to visiting of the ‘gaolbirds’ and their special prison clothes.

The sketch is beautifully written and it is very funny but its humour is biting – it is a black comedy.  It isn’t hard to spot that the two doctor defendants are - only thinly disguised - Dr. Bedford Pierce, Medical Superintendent of the Retreat (he is ‘Dr. Selfopinion’) and Dr. Henry J. Mackenzie,  the Retreat’s Assistant Medical Officer (caricatured as ‘Dr. We’llsee’). The plaintiff and author – the ‘Paying Guest’ – is Ralph H., who was a patient at the Retreat in 1922. The sketch focuses on the relationship between the doctors and their patient and it is really intended as an indictment by a patient of his two doctors – a patient’s revenge, if you like. This makes it not only a funny sketch but also a particularly interesting document – reflecting the mind and thoughts of a patient and shining a light into the life and people at the Retreat at that time.

Ralph H. - the ‘Paying Guest’

Who was Ralph H.? His case notes are in RET6/5/1/24A and there are also files of correspondence in RET/6/20/1/8.

He was a patient at the Retreat no less than six times between 1919 and 1930 – dying during his last stay.  He first arrived as a voluntary boarder aged 54 in 1919, suffering from depression. After returning home he made a suicide attempt in 1920, and was sent to Ashwood House, a private hospital in Kingswinford near Dudley, under the care of its doctor, Dr. Pietersen. Whilst there, he became manic and unmanageable, and in September 1921 he was transferred to the Retreat, where he stayed until October 1922. He came to the Retreat, as a voluntary boarder, on three further occasions: January – June 1923, August – December 1923 and March – May 1925. For most of this time he was suffering from depression. In August 1929 he was admitted to the Retreat under an Urgency Order. He was then suffering from cancer of the larynx and he had been in London, being prepared for an operation, when he began to suffer once again with an attack of “elation and general over-activity” which made his behaviour difficult to control; in the circumstances the operation was postponed and he returned to the Retreat for his mental recovery. However he died there, of cancer, before the operation could take place.

What was wrong with Ralph? Nearly all the doctors who saw him were agreed that this was a manic depressive psychosis – we would say today that Ralph suffered from bipolar disorder. He had periods of clinical depression alternating with periods of manic behaviour. During his manic phases he was excited, difficult and troublesome. He had a persecution complex, which was manifested primarily against his carers. At Ashwood House in 1920 he had been “writing reams of libellous screeds, novels, diaries etc” against Dr. Pietersen and his staff. After his transfer to the Retreat, Dr. Bedford Pierce noted in October 1921, “He says exactly the same in speaking of me and Dr. Mackenzie as he has done of Dr. Pietersen”.  

Mock Trial 34.jpg
Letter from Ralph H, filed in his case notes,
accusing Dr Mackenzie of defamation of character, dishonesty and theft

He was noisy, abusive, swearing at the doctors and nursing staff. He was frenetically busy in devising nonsensical inventions and trying to send out letters to people who might promote them.  He also sent amorous letters to ladies. In return for his freedom to walk into the city of York, the Retreat made him promise not to post letters or make purchases, but these were issues hotly contested between Ralph and his doctors, because he believed (wrongly) that his letters were censored, or stopped, that there was a plot against him and that all doctors were dishonest. On one occasion he walked out of the Retreat and went to Tadcaster to see a solicitor friend. The Retreat was soon contacted and two attendants were sent to escort him back. His liberty was reduced and he was placed for the next three days in a more secure ward, away from his usual room in the Gentlemen’s Lodge which had an ‘open door’ policy.

Once you know this context, you can understand more of the details of “A Mock Trial”. The sketch, for examples, alludes to the issue of letters being opened:

COUNSEL: Now tell me this, doctor. Did my client write a letter to his Solicitor, about the 17th December last, and did he post it?

Dr. WE’LLSEE: He did, I believe, and he posted it in the hall box kept for the purpose, so that the spelling and expressions of delight at being there, should be verified by me.

COUNSEL:  Was the letter sealed by my client, with his crest on?

Dr. WE’LLSEE: It was, but as I had an impression of the seal taken in sulphur I opened the letters to check the contents….

The story of Ralph’s escape to Tadcaster follows:

COUNSEL: What happened next?
Mock Trial 32 jpg.jpg
Dr.WE’LLSEE: Yes I did. I thought it my duty to his wife. Further, I and my colleague, decided we would put him in the “drying chamber” on arrival, commonly called the “Egg Pit”… it took us three days to get him thoroughly dry…

As one can see from this extract, the ‘allegations’ in the court scene are amusing, and yet have a serious side: they make more sense set alongside the narrative in the case notes and correspondence, and also in Ralph’s letters to the doctors, where the same complaints and topics are aired. “A Mock Trial” is very much the product and the story of Ralph H.’s illness.

When Ralph was not in his manic phase, he appreciated the care at the Retreat. He was keen to come back to the Retreat in 1921 of which he “retained a kindly recollection”: the doctor at the Retreat, he said was “an honourable, straightforward gentleman”.  The Retreat had the sports and facilities he liked: he could garden, play croquet, bowls and tennis. Ralph was a wealthy man: a Birmingham businessman, who occupied a room in the Gentlemen’s Lodge which cost between 7 and 10 guineas per week. The standard of accommodation was that of a comfortable, high class hotel.

Gents Lodge.jpg
Dining room at The Gentlemen’s Lodge

Ralph was a typical well-to-do patient: he enjoyed golf and fishing (there was correspondence over whether he was well enough to have his fishing tackle). He was naturally articulate and demanding, whether he was well or ill. His family too, as evidenced by the letters, were caring, but also assiduous and exacting. Part of the fascination of the correspondence is in how it reveals that the psychiatrist in a middle class asylum always had to act in concert with the patient’s friends and family, who could (especially if the patient was there on a voluntary basis) simply remove the patient elsewhere. The Retreat depended on the sizeable fees of the wealthy, and also on its reputation. The evidence shows that Dr. Pierce dealt with patients and family alike in a courteous and unflappable manner. This was not, however, the attitude of the Harley Street consultant who, at Mrs H.’s request, and with the consent of the Retreat, examined Ralph in July 1922. He afterwards wrote a confidential ‘doctor-to-doctor’ letter to Dr. Yellowlees (who had just succeeded Dr Bedford Pierce as Retreat Superintendent), saying, rather naughtily: “All I have to say in conclusion is that if you could persuade Mr H. that on dismissal [from the Retreat] he would have to live with his wife, you might find him quite ready to remain on indefinitely”.  The Harley Street doctor plainly thought Mrs H. interfering. But a much fairer conclusion would be that life for Mrs H. must have been very difficult and she worked admirably and relentlessly to see that her husband was cared for, with everything possible done to alleviate his condition.

Dr. Bedford Pierce - ‘Dr. Selfopinion’

Above all, “A Mock Trial” is one of my favourite items in the Retreat archive because it paints a perfect little picture – which may be satirical but is also rather touching – of two men: ‘Dr. Selfopinion’ and ‘Dr. We’llsee’ or in other words, Dr. Bedford Pierce and Dr. Henry Mackenzie.  At the time this sketch was written, they had worked together at the Retreat for nearly thirty years. Dr. Pierce was a young man of 30 when he arrived to head the Retreat in 1892. Dr. Mackenzie joined him just one year later. 1922 would be a year of significant change, because it was the year Dr. Pierce retired: by the time Ralph finished his sketch Dr. Yellowlees was already in charge. Dr. Mackenzie stayed on for a while, and retired in 1924. This sketch presents a picture of two doctors at the end of a long, successful and satisfying professional partnership.  The text even alludes to the closeness of this partnership:

COUNSEL: I think on his [the Plaintiff’s] arrival, you and your bosom chum, Dr. We’llsee, who has lived in your house for a great number of years (probably fifty) met my client with open arms.

Doctors Pierce and Mackenzie.jpg
Dr. Bedford Pierce, centre and Dr. Henry J. Mackenzie on the left, c.1900

Dr. Bedford Pierce was one of the great figures in the history of the Retreat. A remarkable man, he was handpicked to lead the Retreat at the ages of thirty, despite having no previous experience of psychiatry. The confidence vested in him was not misplaced: under his guidance the Retreat entered a ‘golden age’. Not only did he oversee the expansion and enhancement of the interior but he saw the extensive reconstruction and opening up of the grounds and gardens, and the introduction of more varied and interesting programmes of activities, entertainments and sports for patients and for staff. He encouraged greater parole for patients so they could venture beyond the Retreat grounds for walks. A talented artist himself, he promoted art and tasteful decoration which brightened the hospital.  He began a pioneering course of mental nurse training at the Retreat, he opened the home nursing department, through which the Retreat sent nurses into people’s homes, and he started the Retreat pension scheme. He was a notable psychiatrist: President of the Medico-Psychological Association in 1919, he was also the first Retreat doctor to be allowed to open his own consulting rooms for his own private patients. He was clever, charismatic and authoritative, and yet also reassuring, approachable, and immensely well loved.

Ralph H.’s portrayal of Dr. Pierce was at once fantastical and yet in some respects based on reality. (This parallels the way Ralph treats his own story in the sketch). His portrayal of ‘Dr. Selfopinion’ is embellished with outlandish detail which plays ‘topsy-turvy’ with the actual Dr. Pierce, but sometimes the real man peeps out. Here is ‘Dr. Selfopinion’ being described physically:

DEFENDANT Dr. Selfopinion: (A tall, thin, shifty-eyed looking man, dressed in a black frock coat, looking very shiny with wear)

The black frock coat was realistic, and Bedford Pierce was tall and thin – the phrase ‘shifty-eyed’ is Ralph’s embellishment. As is the following:

Mock Trial 18.jpg
Mock Trial 19.jpg

The topsy-turvydom here lies in the fact that Bedford Pierce was a Quaker – racing, card playing and financial fraud were opposite to the figure of the real man.  And yet, ‘Dr. Selfopinion’ is presented as the figure of authority that he was. There is also a long speech in the sketch where ‘Dr. Selfopinion’ describes how he is acting in accordance with the plaintiff’s wife’s instructions (‘I was to keep him in cotton wool’), which as the correspondence file shows was based on truth. And ‘Dr. Selfopinion’ is described as ‘playing a strenuous game at billiards’ and being in the hockey field, which also reflects Dr. Pierce’s participation in sports – both he and Dr. Mackenzie played in the Retreat men’s hockey team.

Hockey team.jpg
Retreat men’s hockey team, 1902:
Dr. Mackenzie, centre back row and Dr. Pierce, front left (with dog) - RET/1/8/4/15/1

‘Dr. Selfopinion’ also says:

At the end of March I was obliged, owing to a temporary attack of senile decay to retire from my activities, but the Government Department who keep an eye on my house, asked me just to look in once a week, to see that the garden vegetables were getting on all right, so I consented.

This must refer to Dr. Pierce’s retirement in summer 1922, after which he became a Lord Chancellor’s Visitor to asylums (he was later a Commissioner of the Board of Control).

Dr. Henry Mackenzie - ‘Dr. We’llsee’

Ralph H.’s portrait of Dr. Henry Mackenzie is also composed of the same mixture of fantastical and real. Dr. Mackenzie was Bedford Pierce’s right-hand man – reliable, loyal and efficient. Dr. Marjorie Garrod, the daughter of Dr. Pierce, who grew up at the Retreat, describes Dr. Mackenzie in her short but valuable reminiscence, ‘The Retreat was my Home’ (RET/1/9/2/1).
In this, she describes him as ‘a dour, solemn Scot’. In his overflowing study, he would ‘solemnly stand and talk to us cracking each of his finger joints in turn and blowing through his moustache ’. In ‘A Mock Trial’ Ralph adds to ‘Dr. We’llsee’ a touch of incongruous, fantastical frivolity:

COUNSEL: I should like your colleague, Dr. What’s his name? Oh, I remember now – Dr. We’llsee, to step forward.
Mock Trial 30.jpg

However, Ralph mocks Dr. Mackenzie’s Scottish accent, presenting it in an exaggerated way, and with an additional dark undertone:

COUNSEL: Well! My client came to stay in the house in which you live part of the day, but sleep outside, on the front door mat.
Mock Trial 31.jpg

Dr. Mackenzie was the doctor whom Ralph saw most of, on a day to day basis, and the doctor who wrote up Ralph’s case notes. For this reason, the examination of ‘Dr. We’llsee’ in the witness box concentrates much more on Ralph’s detailed grievances, and perhaps he is treated less sympathetically. One wonders if the phrase ‘we’ll see’ was one that Dr. Mackenzie frequently used to mollify Ralph’s more outlandish or abusive claims. But in other respects, Ralph also captures the real man: ‘Dr. We’llsee’ is said to be ‘always busy in looking for eclipses of the sun, catching mosquitos, etc’. In reality, Dr. Mackenzie kept accurate statistics of meteorology through his rain gauges and thermometers and had, according to Marjorie Garrod ‘an unending fund of knowledge about scientific and mechanical things’.

...and finally

My last thought about ‘A Mock Trial’ is a question: why does it exist in a typed version? Who typed it up and why? Ralph’s original would certainly have been in manuscript. When he came to the Retreat in September 1921 he was busy writing a book, apparently about asylums. This seems to have been sparked by his experience at Ashwood House, whose doctor and staff first bore the brunt of his persecution mania. Dr. Mackenzie noted that he ‘spends much of his time here in writing a book to expose the iniquities of Ashwood House’; though there was also an indication that it would contain ‘no names’. Dr. Pierce told Mrs H. in September 1921 that Ralph was demanding a typist to make a fair copy of his book, but Dr. Pierce thought it looked ‘feeble, disconnected and uninteresting’, and so he had told Ralph that no publisher would want it. Clearly ‘A Mock Trial’ is not that book. Written during the following summer, one wonders if its form was actually inspired by Ralph’s experiences at the Retreat, whose stage entertainments and shows, as Harold Hunt describes in A Retired Habitation, often included ‘topical jokes’, sketches and allusions to staff. Ralph’s writing had also improved – ‘A Mock Trial’ is tightly written and to the point. One must conclude that the Retreat sanctioned its being typed up. No doubt the doctors would have found it valuable as a record of Ralph’s mind. But one also hopes that, accustomed to those jokes in Retreat shows, they also laughed and appreciated its humour.

More information about the Wellcome Library funded project to digitise the Retreat archive can be found on the project pages of our website. Digital surrogates from the Retreat archive project are available via the Wellcome Library.

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