London is a locus for medical achievement and history. But its past is as complicated as it is congratulated.
“Wow this really is the place to get sick!” My mom remarks as we drive through the city upon my first moving to London.
Macabre and foreboding, but not out of left field.
The London landscape is dotted with monoliths to our achievements in medicine. We have several hospitals and urgent care centres throughout the city, and driving down Oxford you’re flanked by an array of chiropractic and dentistry clinics. London makes healthcare seem as choicey and voyeuristic as your recent David’s Tea selection process.
Coming from a one-horse town with a single regional hospital, I looked at these structures as testaments to modern healthcare and thought about what capable hands I was in. When you invest millions of dollars into the façade of your cathedral, chances are you’ll have some converters.
The here and now of London and Western medicine is not one without faults, but it is one whose structures echo the kind of teleological progress that healthcare aims for.
They’re shrines to a complex past.
To look back on London’s healthcare past is as easy as looking at the shiny verandas of it’s present.
Just a glance down Highbury at the St. Joseph’s Regional Mental Health Care centre will accomplish both. Sitting at the back of the building lies a complicated locus for mental health history in Southern Ontario.
Still standing is the main examination building and the infirmary of the 1870 “London Asylum for the Insane.” A previous name that bears the weight of the controversial Western history of mental health treatment and diagnosis.
We still have a long way to go when treating and discussing mental health, like not just having conversations about it when Bell tells us to. But it’s worthwhile to check back to where we’ve come from and use that sometimes misguided knowledge to inform our present and future.
It’s a worthwhile challenge to acknowledge how stigmas have changed their faces but not completely disappeared. How the intersection between mental health treatment and society has historically been a contest where almost always the former suffers for the upkeep of the latter.
It’s not pretty, but it’s important to recognize.
The centre was renamed the “O-ntario Hospital for the Mentally Ill” in 1932. Then, in 1968, “The London Psychiatric Hospital”, before opening its doors as the current St. Joseph’s Mental Health Care. The former LAI lies abandoned and partially demolished now, but its halls were once filled with people who lived and worked according to the precursory version of mental health care.
Care that at times offered more of a glimpse into the surrounding social realm than the needs of the patients within.
Here’s a small snapshot of what it was like to be a part of the LAI back then.
Perhaps the most published and notable part of the facility was its use of “moral therapy.”
First introduced by the LAI’s first superintendent Dr. Henry Landor, moral therapy had the patient working towards the goal of being integrated back into society as a “productive” member.
This was a normative therapy that reflected Victorian middle-class attitudes. The patients did gendered work – gardening for male patients and sewing for female patients. As part of the very Victorian work and leisure curriculum, the patients joined in amusements likened to those outside the facility. Such amusements included theatre, musicals, and sports.
These events were recognized by the community. Locals attended the shows and newspapers wrote and reviewed patient theatre performances and sporting events. The LAI even organized tours as a means of generating public interest, where families could take day trips and look at the LAI and its patients.
Public spectacle or patient special interest?
Whatever moral therapy accomplished, it was largely in favour of the appearance of what dictated normalcy back then.
“Insanity” and the Patient
It’s rude, it’s broad, it’s unemphathetic, and it’s scientifically incorrect. Shall I go on or do we get the theme here?
“Insanity” was a diagnosis for any socially unacceptable behavior. Stuff like masturbation, prostitution, depression, old age, working women, mental disabilities, and senility would garner you the verdict and a place in LAI.
It was, as you probably guessed it, a harmful social term used to remove any people not behaving “normally” from the public sphere.
With such a breadth of diagnosable behaviors, some families used the LAI strategically. In tough financial times a family member would be committed for short periods of time. For abuse cases, committals to the LAI would allow sanctuary for the abused as well as the abuser.
Victorian anxieties about modern urban life and its increasing industrialization heavily influenced who people thought were most “at risk.” An anxiety evident in the popular Victorian belief that single women, immigrants, and lower classes were the most susceptible to mental illness.
The “Hysteric Female” and Hysterectomies
Perhaps you’ve heard of hysteria. If your uterus ever sent you a postcard from the South of France you’ve definitely had it. It was medically defined as the “travelling uterus.”
According to Victorian science that’s definitely 100% not based on any sexist attitudes, your uterus literally floats around in your body and causes all sorts of nervous and erratic behaviors.
Hysteria was a common diagnosis at the LAI. Where women were diagnosed with the disorder and committed for any sort of socially scandalous behaviour. In some cases hysteria was an acceptable excuse that meant saving families’ reputations in exchange for committing their daughter.
Dr. Richard Maurice Bucke, LAI’s superintendent from 1877-1902, personally took it upon himself to cure the hysteria of the female patients. With little support from the medical field for his actions and beliefs surrounding hysteria, Bucke performed over 200 surgeries on the female patients.
From 1895-1898 alone, Bucke performed 16 hysterectomies, 12 removals of “diseased” ovaries and tubes, 22 operations involving placing the uterus in the correct position, 30 on the cervix, 21 for minor uterine diseases, and 8 for vaginal lesions.
Critics called his intervention the “mutilation of helpless lunatics.”
Hear their voices.
I want to leave you with the voice of one of the patients. This powerful poem testifies to the humanity of the people who once lived within the LAI’s walls.
“London Asylum Dec 30/
I hereby inform
you: that you are a con-
quered enemy. I have
overcome the Devil: whom
you represent. And as
the rightful result. I
demand your keys; which
represent your authority
and position in this Insti-
By command of my Lord
I’d like to thank Western Archives for the wealth of research materials! I strongly encourage you to check out their project and learn more about the LAI.
Feature photo via the Exploration Project, you can read their article on the LAI here.