Sunday 20 August 2017

The man who railed against Ireland's shameful Bedlam

John Spain

To students in Dublin in the late 1960s, Ivor Browne was a kind of god. Although he was Professor of Psychiatry in UCD, he supported the student revolution in Earlsfort Terrace in '68, he smoked dope, he took LSD, he played jazz, he would get down on the floor and talk about changing society. That was just for starters.

He was also someone who had travelled around Ireland in his own student days in the late 1940s, playing traditional music for his supper like a hippie, before hippies were even heard of.

He was a god to the students because he was a radical thinker and a free spirit. Years later he became a devil to the jobsworths in the Department and the psychiatric profession because he pushed psychiatric care into realms that they could not handle and still get in enough golf. They didn't exactly crucify him for it but, like Christ, he was driven out.

In between these two points Ivor Browne was at the forefront of psychiatric care in Ireland, transforming the way we treated the mentally ill. He was a charismatic individual with little ego or interest in money, a powerful intellect, enormous energy and a compulsion to change both himself and Irish society from within.

Unlike those who saw medicine as a ticket to status and wealth, Browne was filled from the beginning with a spirit of public service, a burning intellectual curiosity about new ways of treating the mentally ill and a determination to change the inhuman mental hospital set-up which locked people up and then forgot about them.

The story of all this is contained in his new book, published this week. It's called Music and Madness, part memoir, part medical history, part diary of self-discovery, part guide to theories on mental health, complete with diagrams. But above all it's an entertaining and moving account of one extraordinary man's life.

Ivor was born in 1929. He was part of a well-off family in Sandycove with a father who worked in the head office of a bank, but Ivor was a dreamy, often miserable child. His father was fond of telling friends, within the boy's hearing, that he was a "mistake".

Despite having a home in an idyllic setting, with a boat in Bullock Harbour for fishing and their own "field" near the house to play in, Ivor failed to blossom. "I was seen as something of a problem and not the full shilling." He was isolated from both his siblings and their friends in the "field". And it got worse when he got to Blackrock and they wanted him to play rugby. He ended up at the age of 14 in 3E, the slow learners' class. His father, preoccupied with his own life, barely noticed.

By then, however, Ivor had discovered the trumpet and jazz and he left Blackrock. The way the teachers roared at some of the slower kids had sickened him.

"I was acutely aware of what was going on and of the stupidity and injustice of it." Despite his apparent failure, there was an observant, independent mind already at work.

He ended up in a secretarial college, but passed the required subjects to get into the College of Surgeons at the age of 17. He was on his way, although he "only took up medicine to keep my parents off my back... I was determined to be a jazz musician."

His progress was slow and interrupted by lengthy bouts of TB but eventually he found himself in 1955 a newly qualified doctor. His professor of medicine at the old Richmond Hospital told him: "You're only fit to be an obstetrician or a psychiatrist." That suited Browne, since he had little interest in general medicine. He started his internship in the country's main neurosurgical unit, where he assisted one of the surgeons on Saturday mornings.

"Nearly every Saturday morning one or two patients would be sent down from Grangegorman to have their brains 'chopped'... this was the major lobotomy procedure... where burr holes were drilled on each side of the temples and a blunt instrument inserted to sever the frontal lobes almost completely from the rest of the brain."

This barbarity was accepted practice at the time. It was supposed to "calm" patients. "It did succeed in doing this," he writes, "but in the process many patients were turned into vegetables." By now any hopes of a jazz career were gone and psychiatry beckoned. Over the next few years he worked in various hospitals around Dublin and what he witnessed is almost past belief.

For the 2,000 patients in Grangegorman, the conditions were medieval. "Many of the wards at that time had upwards of a hundred patients in them... there were crowds of patients all jostling each other, some of the women with their dresses pulled up over their heads, and here and there a nurse struggling amid the chaos." The reason for the overcrowding was that "although disturbed patients were constantly arriving in admission units, relatively few were being discharged". Patients were shunted around to make room, mildly disturbed patients ending up in chronic wards where they sank into depression and stayed for years, lost in the chaos. It really was Bedlam.

The other institutions around Dublin were much the same, with head psychiatrists who ran them like personal fiefdoms. Out in St Ita's there were another 2,000 patients and new arrivals were assessed on the basis of their suitability for work on the farm, in the laundry, the coal yard etc. There was no real treatment, apart from some drugs.

But Browne had by now also worked in Oxford, London and Harvard and had seen a different way of dealing with the mentally ill. It involved new drugs and intensive one-to-one therapy, closing down the old institutions and moving patients back out into the community where they could learn to function again.

And all this time Browne was working on himself, shaking off the effects of his isolated childhood and using LSD to explore his own psyche.

He seems to have worked in all the mental institutions in Dublin at various times. So when he became Chief Psychiatrist, he knew what to do. He shrank the old institutions and gave patients real therapy aimed at revealing whatever traumas had made them sick, instead of "calming" them with medication and locking them away.

All this is only a fraction of Browne's story. The book tells, for example, of a day he spent on a bender with Brendan Behan, how he nearly got to drop acid in the US with Timothy O'Leary and what went on when RD Laing appeared drunk on the Late Late.

There's a whole chapter on his young patient Phyllis Hamilton, who ended up in St Loman's after being abused by her father... and that was before she met the other father, Michael Cleary. Browne has a lot to say about that relationship and the way she was treated after Cleary's death. There was the outcry that followed when he said he smoked hash when listening to music and the media went crazy and called for his head.

Interwoven throughout is his love of music, American jazz and Irish traditional. He was good on the tin whistle, he knew many of the old uilleann pipers personally and he was there at the start of the Piper's Club, which lead to Comhaltas and the first fleadhs. Then there was India, where he made several long trips, and found his own personal teacher.

All told, Music and Madness (Atrium, €25) is a fascinating insight into the mind of one of Ireland's true thinker-pioneers and, in passing, into Ireland itself. It's going to be this summer's big bestseller.

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