Guest blog post from Mark Doherty, Lead Nurse for Mental Health Services for Older People (MHSOP)

November 15th, 2016 by Admin Leave a reply »

A Lack Of Strangeness —A Personal Memory of Whitchurch Hospital

Since GoogleEarth accepted Wales into the international community by allowing it the unforgiving scrutiny of the high-resolution image, it has been possible to extend the godlike aerial gaze to the rooftops of Whitchurch Hospital, its spindly angular corridors, its abundance of redbrick, its green quadrants, rotting gazebos and of course the tower. I can’t help but think it must have been a Sunday when the photographing satellite went over: there are too few cars in the car park, for one thing, for it to be a weekday.

Google Earth screen shot

Otherwise, the image contains in detail all those elements that will be familiar to anyone who ever worked, or was admitted, or visited, or trespassed there. From about 1000 feet, it has a very particular shape; there are still many Edwardian psychiatric institutions in the country but, from space, nothing looks quite like Whitchurch Hospital.Arguably, less detail gives you more aesthetic information: in the old, low-resolution version one was forced to conclude that the blurred thing on the screen had an insectoid, or arachnoid , shape to it. There is no denying this: there is a main body, a thorax, a head, and a symmetrically-arranged number of jointed arms. This organic shape is apparent from ordinance survey maps too, and has always coloured my own view of the building and what it is, what it gets up to. But the main business of course, all the thinking, does not go on in the head—it happens in those clawed legs, where the wards are. One by one the legs are being tourniqueted-off: Whitchurch Hospital is a big rambling Edwardian psychiatric asylum, presided over by one of Enoch Powell’s isolated, brooding and majestic water towers and, as determined by Powell it is closing, forever.Once you start the process of closing down a hospital there is no turning back. The wards that close first manifest a kind of architectural gangrene, and the rot will spread throughout the building with no regard for the timescales of the planners. Wards West 5 and West 5a were already closed when I first worked here, thirty-one years ago: if you put your eye close the grimy glass in the door, and ignore the absence of floorboards, the bleached empty beer cans, the desiccated leaves, you can almost see what a National Health ward looked like in the 1950s. If there are ghosts, they are the ghosts of Dirk Bogarde and Hattie Jacques. But the Western extremity of the hospital has died along with the wards, and the communicating corridors are full of graffiti and smell of urine. Hattie Jacques would not have stood for this.The fact is that Whitchurch Hospital will not officially and completely close for a few months yet, but working in it is a vastly different experience from what it was only fifteen or twenty years ago. Then, there were two large nurses’ homes in addition to the medical quarters, and the hospital had its own social club, none of which was considered compatible with the vision of a modern mental health service. Undoubtedly in the early part of the century those nurses’ homes would have been segregated male and female, but in my time (there was a lot of Duran Duran and Boy George about; we drank cider and cheap wine when the Tube was on in the East Homes Television Room) the culture was emphatically a mixed one. There were parties. There was much commerce with the nearest pub, the Hollybush, which closed just in time for the hospital canteen to open for the night shift, where the lovely Beryl would serve sausage and chips.In fact, my office now is what once was the television room of the East Homes. I won’t go into any of the hallucinatory images from the past that now continually haunt me as I sit at my desk, super-imposed on the present-day anaglypta, but it is safe to say that nurses’ homes, television rooms and all, can be fun places to be. If there are ghosts in my office, rest assured they are all having a good time. One of the mildest memories I have is of leaning out of the window with a guitar in the middle of the night, singing the song American Pie, and waking up the patients on Ward East 1. I was young, we had been drinking. The night air on the other side of that window frame was warm and fragrant, incidentally: it was the summer of 1983 and Whitchurch Hospital was a glorious, complicated, redbrick building enfolded in thick greenery. I would wake with a hangover, reach for my fags, and go to work on whatever ward on which I happened to be placed. But work on the wards was really only an incidental sideline—what was really important was this vibrant social life I was experiencing in this liberated commune that happened to be a nurses’ home in the middle of a psychiatric hospital. As I say, I was young: it had not yet dawned on me that the real life of the hospital was what was happening out there on the ends of those spider-limbs, in the wards. I was living in a pleasant old building in a sort of leafy village; occasionally I was required to go to work.We were, of course, a little culture co-existing with other cultures in the same way that radio stations can occupy the same electromagnetic spectrum and yet hardly interfere with each other at all. There was, for instance, a whole army of professionals including psychiatrists, occupational therapists and nurses, trying to provide a range of services to people with mental health problems. There was a taxonomy of clinical areas, not all of which has survived: Acute, Long-Stay, Medium Long-Stay, Psycho-geriatrics. We can hardly be surprised that that last one hasn’t made it to 2014: when I first saw the dangling NHS green Perspex sign pointing to the Psycho-geriatric ward (I was nineteen years old, I hadn’t a clue what it meant) it was all I could do not to think of Anthony Perkins. We soon found out what Psycho-geriatrics really meant, though, and in a way it was no less disturbing: I was nineteen, and here were people who were dementing, whose very essence was being drawn away maliciously by some organic process. I was profoundly affected to learn that I would actually be obliged to feed people, and indeed one person who trained with me saw this happening one day and did not return the next.Many of the staff were from families that had long had a working relationship with Whitchurch Hospital. The Nursing Assistants, in particular, were the sons and daughters of other Whitchurch Nursing Assistants. Students and even qualified nurses were viewed as fly-by-nights. These NAs were often from north of the M4, from the valleys, where, at that time, a whole other culture was operating, and a malignant one at that: those NAs would be from families where somebody was working in the pits. Or not, as the case may be: it was 1983, 1984, the height of the time when Thatcher was making her point about precisely how important individuals and communities were in her particular vision of the future. That sense of grievance and militancy was seeping into the wards: those Nursing Assistants, it wasn’t a good time to mess with them.There was, of course, another culture in there, with its own inalienable point on the spectrum: that of the patients. Although this was a really whole range of cultures: the patients on the Acute wards inhabited a sort of existential bridge between the hospital, and real life, because they were people who had jobs, wives, children, their own houses; it was just that something had temporarily gone wrong with them, somehow. And what experts we were at categorising precisely what it was that had gone wrong, and, by extension, categorising the people themselves: this person is a MANIC DEPRESSIVE, this one is a SCHIZOPHRENIC, this one over here (on the “secure” ward, no doubt) a PSYCHOPATH (Tony Perkins again). How blithely we accepted the diagnostic labels dispensed by our medically qualified leaders, without thought for the effect this would have on the individuals. We’re better at this now, but only slightly. And please don’t assume that I think that mental illness does not exist: it does. I just don’t think we know as much about it as we think we do. The other thing about patients on Acute wards: they had visitors—evidence of the temporary nature of their illness.Unless it was not temporary. If whatever it was that ailed them did not go away, then they probably had a “chronic” illness, and would then graduate to a medium long-stay ward for “rehabilitation” which, frankly, was for life. When people talk about institutionalisation, this is what they mean. People who were absorbed into this category would join a pantheon of “characters” that extended in time back to the birth of Whitchurch Hospital. Any old psychiatric hospital has its “chronics”—people so damaged firstly by their illness and secondly by the soul-destroying patterns of existence that a psychiatric hospital imposes, that they are compelled to conduct themselves in endless circles of repetitive and bizarre behaviour. It took us a long time to understand that it was the hospitals themselves that were making this happen. This is why we try not to admit people at all, any more, in case we contort and distort them the way we used to. It is far better to let real life contort and distort people instead.

Once, one of the “characters” died of old age, in his bed. His heart stopped. I heard the emergency call, and was told to rush up the stairs with the defibrillator, which in those days was the size of a fridge. The cables and paddles fell off and got tangled in my legs. When I finally got to the “chronic” ward it was, of course, too late. The ward staff were stricken with grief. “Good old_____” said one of the Nursing Assistants, “…he was a perfect patient, he was. He never shit the bed once.” You have to believe me when I tell you that the staff were genuinely upset by the death, and that the Nursing Assistant’s comment was meant as an expression of his admiration for the old guy. With such modest levels of acceptable behaviour, it is hardly surprising that we created a group of patients whose behaviour was totally unfit, and never would be fit, to survive in the outside world.

So we don’t do that anymore. In fact we hardly ever admit anybody at all, if we can help it; and even when we do it is for the shortest time possible, lest the toxins of the institution affect them. This is undoubtedly a good thing, and yet I worry, because I have a personal conviction that the outside world is as much a deforming institution as Whitchurch Hospital and its like ever was.

It is true that, as with many old institutions, Whitchurch was built on the outskirts of the city so that the unpalatable fact of mental illness could be kept at a distance and not cause offence. It is also true that the city then advanced to encompass the area of Coryton, and for most of the last hundred years the denizens of Whitchurch and Coryton have had to live with the redbrick spider and its green-domed water tower looming over them. It is fair to say that the local residents have coped quite well with this terrible burden. People who do not live in such circumstances are faintly discomfited by the idea—it must be like living next to a high security prison or a nuclear reactor: you are always waiting for the breach of protocol that leads to the escape of convict or radiation, or lunatic. But the locals in Whitchurch know the same thing that the locals in Cefn Coed or St. Cadocs also know: that the presence of an old psychiatric hospital in your village means precisely nothing; it is almost boring, because when the in-patients come out to shop or visit the pub or bank, it is a complete non-event. There is a disappointing lack of strangeness about those who have been diagnosed as mentally ill.

But people want it to be strange. Back in 1983 I had been out on the town one evening and had taken a taxi back to the Homes. Somewhere along North Rd., Drive said to me: “So you lives in Whitchurch ‘Ospital, then, is it?”

I replied in the affirmative. Drive narrowed his eyes a bit, gave this some thought, then asked his question: “Something I’ve always wondered about that place,” he said, “do you ‘ave much trouble with ’em howling in the night?”

I replied in the negative. He was clearly disappointed. He wanted, no doubt, tales of awesome lunacy, but I had none to tell.

Here is another memory from 1983. Every Saturday night, the Great Hall would be pulsing with pop music and chatter, and there would be a beery odour. Not a patients’ social function, not a staff reunion. The corridors would be full of drunken, unfamiliar people. Whitchurch Hospital was hired out on Saturday nights for wedding receptions; now, almost a quarter of a century on there must be at least some of those marriages surviving, with their memories of one humid and crapulent night in Whitchurch. It does seem an odd thing to do, and it hasn’t happened for some time, and yet only last week I was driving through the hospital’s main entrance and had to halt the car because of two young men in kilts posing with a bride and groom against a wedding car full of flowers and ribbons, a professional photographer snapping athletically away. How did people come to that decision? Where shall we have the reception, love? Where do you fancy for the photos? Castell Coch? Cathays Park? Cardiff Bay? I know, how about…

I suppose it just supports my contention that a psychiatric hospital is an ordinary place. Nothing, as Phillip Larkin said, like something, happens anywhere. And it’s as good a place as any to hold a wedding reception.

I moved out of Whitchurch for several years. Of course it wasn’t the same when I came back. It was falling to bits for one thing. Like the coal industry, it no longer has a place in somebody’s particular vision of the future, and so it has been neglected and is showing the terrible signs of that neglect.

As a Mental Health Professional whose teeth are getting quite long, I must applaud the closure of Whitchurch Hospital as a symbolic sweeping aside of the ancient asylum culture, clearing the way for a new build that will be fit for humans to inhabit. And I do applaud it. But it will be an ordinary building, the new one, a competent building; you and I know that it will possess not one hundredth of the aesthetic power and romance of Whitchurch Version 1.0. It will lack strangeness. Some of the old building is “listed”, and therefore parts of it will continue to exist to accommodate the flatlets or shopping centre or office facilities that are planned for the site, but it will be unrecognisable. It is difficult to see how the village of Whitchurch itself will retain its sense of character, unless the Water Tower is to remain.

I moved to Whitchurch Hospital to start my Registered Mental Nurse training when I was nineteen. A little room in the East Homes was pretty much my first experience of independent living.

Nurses Homes April 2016
Copyright: Mark Doherty

But the nurse education went on in a building on the other side of the site, in a squat 1950s block. So my lessons were spent with a panoramic view of the hospital and the grounds. I started my training in February 1983. I was overwhelmed by two things: the little jars of real foetuses in the glass-fronted cabinet at the back of the classroom (I have never been able to work out what they had to do with psychiatry), and the view of the hospital with the trees in front of it. In February, the trees were bare and exhibited intricate branch-networks against a white sky, like the diagrams of bronchi, arteries and nerves I was being shown in anatomy lessons. At the age of nineteen, I thought I had been transported into the heart of a massive poem, and am still haunted by that time. If the new flats or offices find that they have a ghost, it may well be mine.

Thank you to Mark Doherty, follow Mark on twitter (@markdoherty1)

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