Friday, April 8, 2011

The World's One Bedlam

Thomas More once observed that London itself was one large madhouse. As counsellor to Henry VIII, he knew a thing or two about lunatics. He had a point, too. You don't need to travel far in London to see some poor soul muttering to himself, conducting imaginary conversations, or ranting out loud, and that's just in the Houses of Parliament (ahem.) The city seems to attract the lost and the befuddled, and probably creates many more.

So it's no surprise that it housed the world's first lunatic asylum, Bethlehem Hospital, which later became universally known as 'Bedlam.' The word has entered the English language, used to describe chaos, disarray or tumult. (Interestingly, another London mental institution has given us a synonym for someone deemed mad. St Mary's was in the east end borough of Barking, and the latter is colloquially used to describe someone who acts strangely or out of the norm.)

Bedlam still exists, known as the Royal Bethlem Hospital in Bromley, Kent, though thankfully it has managed to shed much of the stigma attached to it, in the same way society has with mental illness, up to a point at least. It has been always been a portable institution. It first opened as a priory in Bishopsgate - now home of Liverpool Street Station - in 1247 and started admit the mentally ill from 1357. Over time it gradually admitted more until its sole purpose was a psychiatric hospital. A pretty disgusting one. Stories of the depravities inflicted upon the inmates are legion, but some of them were allowed to come and go and wander the streets where they were viewed with dread as well as pity and forced to wear a tin badge to mark them out. Inside the walls, one witness wrote, the screams and moans were 'so many, so hideous, so great; that they are more able to drive a man that hath his wits rather out of them.'

An image of the Bedlam built in Moorfields
Bedlam had become so squalid by the mid 17th century that it became a civic scandal, and so it was moved to Moorfields, where it soon became a symbol for all that was evil and iniquitous about London, employed as a metaphor in the poetry of Alexander Pope and depicted by that great chronicler of London's lost and neglected, William Hogarth. The same was the case when it moved for a third time to St George's Fields, Southwark, in the early 19th century. The building was grand and imposing, yet inside the conditions were still stark and disturbing. Inmates were restrained, chained and often drugged, and the moans and screams persisted. There was a monthly ball where the patients danced with each other, which creates a bizarre image. But by the 1930s people had had enough of housing a centre of madness in a city teeming with it, and it was moved out to the country, given a whole meaning to the phrase 'Out of sight, out of mind.'

An 18th century map showing the site of the Bedlam graveyard
Yet, as always, the past refused to be forgotten, and this week London had to confront again its lunatic ancestors. Building on Crossrail, the long-promised railway that will 'speed' commuters across central London, it says here, had to be halted this week near Liverpool Street Station when they dug up hundreds, possibly thousands of human remains, on the site of what was the graveyard in the original Bedlam. The bodies will be removed for study - what age, what sex, what maladies did they suffer from - and some might could well be housed in the Museum of London, though regulation stipulates they need to be relocated in a place as close as possible to their original graves within two years of discovery. Crossrail is going to cause a huge inconvenience, but interesting finds like this are likely to become more common, and if it offers tantalising glimpses into the city's murky past like this one the hassle might all be worth it.


Dan - Friday


  1. Being a voracious reader of mysteries that are set in London, I knew the bare bones of the Bedlam history (no pun intended given the discovery). The tragedy is that, in many ways, the mentally ill are still not treated with dignity.

    In a cost cutting measure close to thirty years ago, it was decided that the mentally ill would do far better if they were living outside the walls, becoming part of the community at large. The patients who were given regular doses of medication appeared to be able to adjust to life outside; no one considered that when no longer supervised they would not take the medication. I prefer not to think that the policy makers did consider this possibility and didn't care.

    In 1967, Frederick Wiseman, an attorney turned documentary film maker, got permission from the superintendent of Bridgewater State Hospital to make a film documenting the conditions at the facility. He got permission from all those who were to be in the film, either from those patients who were capable of making the decision or from the superintendent who was their legal guardian.

    Wiseman called the movie "Titicut Follies" after a variety show that had been put on by the inmates/patients. Titicut is a native American name for the nearby Taunton River. The synopsis, as stated on Wikipedia:

    "Titicut Follies portrays the existence of occupants of Bridgewater, some of them catatonic, holed up in unlit cells, and only periodically washed. It also depicts inmates / patients required to strip naked publicly, force feeding, and indifference and bullying on the part of many of the institution's staff." This was in 1967 not 1357.

    Now comes the interesting part of the story. Wiseman released the film in 1967. The state of Massachusetts stepped in and ordered all copies of the film destroyed. The movie languished in courts in Massachusetts although it was shown in Europe. In 1969, the Massachusetts Supreme Judicial Court ruled that the film could be shown to doctors, lawyers, judges and those who work with the mentally ill. The rest of us could not see it. The case went as far as the United States Supreme Court on the basis that the treatment of the patients violated their civil liberties but the court refused to hear the case.

    Nearly twenty years later, families of some of the patients who died there sued the state. Four years later, in 1991, the film was released for the general public. The following year it was shown on public television. Stephen King could not come up with anything more horrifying than the conditions shown in the film.


  2. Beth, that's a fascinating and disturbing story. Not for the first time, more interesting then the one above the line! While the conditions of Bedlam were appalling, we sort of expect it from the dark ages. But as your story illustrates, even in more 'enlightened' times, we still treated the mentally ill abysmally. It was the same over here in places like Colney Hatch, and treatments like electroshock therapy and lobotomies.

    And, as you suggest, the policy now seems to be to rehabilitate patients in the community - 'care in the community' as it was known in the UK, a classic case of Orwellian speak, as little care was involved. The very opposite in fact. It cloaked the reality that spending was cut, hospitals closed, and some very ill people were cast adrift without much monitoring with some predictably tragic consequences.

  3. I was living in Boston when news of Bridgewater first broke. Unbelievable, I thought. A few years later I was practicing law in New York City and doing public service work in its jails, when a then relatively unknown local television reporter, Geraldo Rivera, went into Staten Island's Willowbrook State School for "children with mental retardation" and came out with a national news story shameful even by Bridgewater standards.

    I don't know if you ever saw the film version of "One Flew Over the Cuckoo's Nest," but I still have goosebumps from when I did (not sure what you call them in Bedlamland, Dan).

    It was right on the mark about day-to-day life in any situation where ultimate power over the most routine events in an institutionalized charge's life resides in the keeper.

    Yes, much of that is necessary, but without consistent, meaningful training and some sort of means for bringing third party "outside" perspective to bear, the keeper/kept dynamic will inevitably bring us more of those horrific stories, e.g., Abu Ghraib prison.

    Some psychological change seems to occur when one is given relatively absolute power over another. I believe a clinical academic study in your neck of the woods, Beth, using students as both keepers and the kept, had to be stopped in the first day because of the abuses the keepers were practicing on their charges.

    For those who would say to me, "How dare you suggest such behavior is part of the human condition," I say, "If you really care, accept the reality and deal with it." How? By NOT allowing governments and their agents to put the institutionalized "out of sight, out of mind."

  4. My family has been fortunate in that we have not had a family member in need of psychiatric care so I don't have any personal experience of the system but the people entrusted through the ballot box with caring for the old, the young, and the sick do a miserable job of it.

    Thank you, Dan, but Massachusetts did a singularly miserable job of taking care of the weak and Titicut Follies is a stain that can't and should not be erased. I had a shameful amount of material to present.


  5. My mother was put into a psychiatric ward in New York State in the 1970's - she didn't belong there, she was put there due to overcrowding from the other floors. Treatment of the patients were horrendous, and they were tied to their beds. Nurses partied or left the floor for entire nights, and people died. Having only had Type II diabetes and needing a D&C, and fully aware and intelligent, it scarred her for life.

  6. I do object to the term "tantalizing glimpse" however, that's like saying a "tantalizing glimpse" of the Holocaust. It is man's inhumanity to man, and it is always sickening. Thank you for for the informative article however.