Sir Wylie McKissock, Part II: the patients
Wylie McKissock’s patients came from all walks of life, from doctors and nurses to rag and bone men and domestic servants. They ran the gamut of psychiatric diagnoses from schizophrenia and affective psychosis to neurosis and personality disorder. (A few had no psychiatric diagnosis and were operated on for the relief of pain or tinnitus.) Some had been incarcerated for years, some had never been in a mental hospital. In age they ranged from teens to seventies.
Many were – one way or another – casualties of war: a veteran of the Normandy campaign, physically and mentally injured in the front line; an elderly woman bombed out of her home who found it difficult to settle in a new area; a nursing sister who broke down under the stress of trying to protect her patients from enemy bombardment; a widow unable to cope when her son was posted overseas; a blind man who became obsessive about switching off lights after being prosecuted for contravening blackout regulations; a prostitute who was arrested and certified after being found sleeping on War Department land.
Some patients, especially those with a diagnosis of schizophrenia or mental deficiency, were leucotomised in the hope not so much of a cure and return to life outside an institution, but in an attempt to render them less of a management problem within the institution. “The patient who showed great improvement” wrote Dr Cook of Bexley Hospital, Kent, where by 1943 McKissock had leucotomised 13 violent schizophrenic patients (one died), “was a typical example of the use of leucotomy in chronic schizophrenia. The patient was by far the most violent, animal-like catatonic whom even the most senior nurses in the hospital could remember, and after twelve years of “unapproachableness” she had for over a year been up and about, playing the piano, knitting and doing embroidery. She was still as mentally ill as she ever was, but the nursing relief was very great and she was much happier”.
But psychiatrists at St Lawrence’s Hospital, Caterham, were less impressed with the results on their mental defectives and decided to put an end to the visits of McKissock and his assistant McColl after 5 of 43 leucotomy patients (nearly all under the age of forty) died and others suffered mental deterioration or epilepsy.
It was this particular use of leucotomy – to control the behaviour of institutionalised patients – that was curtailed by the discovery of new drugs in the 1950s. McKissock himself noticed that by 1958 there had been “a marked diminution in the number of deteriorated schizophrenics offered for surgery although a number of dangerous or disturbed patients are still referred and can often be adequately sedated by a standard prefrontal operation”, but he doesn’t appear to have made the connection with the introduction of major tranquillisers. In fact, he generally showed little interest in psychiatry or indeed in the fate of his own psychiatric patients.
Women outnumbered men by three to two amongst those leucotomised by McKissock and, although they were found in all diagnostic categories, they especially dominated the depressed group. Many had unhappy marriages and a few appreciative words from their husband post-leucotomy could catapult them into the recovered category (“he rather likes the severe frontal lobe deficit syndrome” or “Barbara is undoubtedly a much pleasanter companion to live with”). Their misfortune was to fall into the hands of psychiatrists before the advent not of a new drug but of a means of escape via easier divorce and more financial independence for women
Many were – one way or another – casualties of war: a veteran of the Normandy campaign, physically and mentally injured in the front line; an elderly woman bombed out of her home who found it difficult to settle in a new area; a nursing sister who broke down under the stress of trying to protect her patients from enemy bombardment; a widow unable to cope when her son was posted overseas; a blind man who became obsessive about switching off lights after being prosecuted for contravening blackout regulations; a prostitute who was arrested and certified after being found sleeping on War Department land.
Some patients, especially those with a diagnosis of schizophrenia or mental deficiency, were leucotomised in the hope not so much of a cure and return to life outside an institution, but in an attempt to render them less of a management problem within the institution. “The patient who showed great improvement” wrote Dr Cook of Bexley Hospital, Kent, where by 1943 McKissock had leucotomised 13 violent schizophrenic patients (one died), “was a typical example of the use of leucotomy in chronic schizophrenia. The patient was by far the most violent, animal-like catatonic whom even the most senior nurses in the hospital could remember, and after twelve years of “unapproachableness” she had for over a year been up and about, playing the piano, knitting and doing embroidery. She was still as mentally ill as she ever was, but the nursing relief was very great and she was much happier”.
But psychiatrists at St Lawrence’s Hospital, Caterham, were less impressed with the results on their mental defectives and decided to put an end to the visits of McKissock and his assistant McColl after 5 of 43 leucotomy patients (nearly all under the age of forty) died and others suffered mental deterioration or epilepsy.
It was this particular use of leucotomy – to control the behaviour of institutionalised patients – that was curtailed by the discovery of new drugs in the 1950s. McKissock himself noticed that by 1958 there had been “a marked diminution in the number of deteriorated schizophrenics offered for surgery although a number of dangerous or disturbed patients are still referred and can often be adequately sedated by a standard prefrontal operation”, but he doesn’t appear to have made the connection with the introduction of major tranquillisers. In fact, he generally showed little interest in psychiatry or indeed in the fate of his own psychiatric patients.
Women outnumbered men by three to two amongst those leucotomised by McKissock and, although they were found in all diagnostic categories, they especially dominated the depressed group. Many had unhappy marriages and a few appreciative words from their husband post-leucotomy could catapult them into the recovered category (“he rather likes the severe frontal lobe deficit syndrome” or “Barbara is undoubtedly a much pleasanter companion to live with”). Their misfortune was to fall into the hands of psychiatrists before the advent not of a new drug but of a means of escape via easier divorce and more financial independence for women
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