Deep Sleep: Harry Bailey and the Scandal of Chelmsford 0731802160

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Harry Bailey and the Scandal of Chelmsford

BRIAN BROMBERGER AND JANET FIFE-YEOMANS

First published in Australasia in 1991 by Simon &. Schuster Australia 20 Barcoo Street, East Roseville NSW 2069 A Paramount Communications Company Sydney New York London Toronto Tokyo Singapore ©Brian Bromberger and Janet Fife-Yeomans, 1991 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher in writing. National Library of Australia Cataloguing in Publication data Bromberger, Brian. Deep sleep: Harry Bailey and the scandal of Chelmsford. Includes index. ISBN 0 7318 0216 0. 1. Chelmsford Private Hospital. 2. Sleep therapy. 3. Mentally ill — care — New South Wales. 4. Psychiatric hospital — New South Wales. 5. Sedatives — Overdosage — New South Wales. I. Fife-Yeomans, Janet. II. Title. 362.21099441 Designed by Jack Jagtenberg Cover design and illustration by Jack Jagtenberg Typeset in Australia by Adtype Graphics Pty Ltd Printed in Australia by Australian Print Group

CONTENTS

1

Acknowledgements Author’s Note Introduction Early Promise

2

Return and Glory

3

Callan Park Losses and Gains Into Private Practice

4 5

6 7

8 9

—

14

vi

1 14 23 35 42

Chelmsford Private Hospital The Power of Life and Death Libido See No Evil Whistle Blowers Bailey on Bailey

121

The Royal Commission Conclusions Index

139 158 163 173 181

10 11 The Walls Close In 12 Bailey Exposed 13

iv v

56 67 81 98

ACKNOWLEDGEMENTS

In order to write an accurate account of Bailey’s life it was necessary to have access to records which detail his professional life as well as personal information which can only be provided by people who knew him. The availability of the former depended on the courage of the former patients who were prepared to come forward and tell their stories to the Chelmsford Royal Commission; the latter depended on those who knew Bailey being willing to speak to us. These people are all thanked but special appreciation to Jan Allan for her frankness about her life with Harry Bailey. Without the support and help of my wife the book would not have been completed. Not only did she prevent me from lapsing into a mode of writing which is the product of my legal training, but she encouraged me to continue when my desire was flagging. The hearings of the Chelmsford Royal Commission were conducted with skill and sympathy and for this the Commis­ sioner, Acting Justice Slattery, must take full credit. The detail of the report and the extent of the material collected reflects the diligence of the Royal Commission staff led by counsel assisting, Brian Donovan QC. I am extremely grateful to Lloyd Waddy QC, for the 18 months of dedication to his role as senior counsel for the patients and for the insights into life at the bar which he provided. The publishers had the good sense to appoint Susan Morris-Yates as the editor of the manuscript. Without her dedication the book would not have seen the light of day.

B. B.

IV

DEEP SLEEP

v

I would like to thank a few people who were involved in this book in different ways: Jan Allan, who saw it not as an inva­ sion of privacy but as an opportunity to finally tell about the Harry Bailey she knew; Brian Donovan, John McMillan, Chris Geraghty, Jack O’Reilly, Tom Cunningham and Pat Griffin, who took the time and trouble to help with accuracy and were never too busy; Robyn Fennell, Toni Lamond, Dr Jules Black, Dr John Sydney Smith, Professor Leslie Kiloh, and all Bailey’s former college classmates and professional col­ leagues, whose reminiscences helped piece together the jigsaw; and editor extraordinaire, Susan Morris-Yates. And there are some special people who deserve a mention of their own for their enthusiasm and support—Roxanne Clark, Jenny Thornton and, of course, Phil Lock.

J. F-Y.

AUTHORS’ NOTE

We have attempted to piece together Bailey’s life from a var­ iety of sources. We have used information gained from per­ sonal interviews, newspaper reports, New South Wales Hansard, and the sworn testimony of witnesses who gave evidence to the Chelmsford Royal Commission. For narrative reasons we have presented the sworn testimony of witnesses at the Royal Commission in the first person, even though we were not able to interview many of them personally. It has not always been possible to attribute anecdotes, statements and testimonies to the people who gave them because we have been careful to protect the privacy of individuals. Frequently those who spoke to us asked not to be named, while some of those who gave evidence at the Royal Commission into Chelmsford, as well as at other inquiries, hearings and inquests, have had their names legally suppressed.

INTRODUCTION

Our mutual involvement in the whole Chelmsford episode began from two totally different perspectives. Brian Bromberger, a legal academic, had spent more than a decade attempting to persuade the relevant authorities to investigate Chelmsford and found himself representing over 100 former patients and their families at the hearings. Janet Fife-Yeomans, chief court reporter for the Sydney Morning Herald, under­ took the day-to-day reporting of the proceedings of the Chelmsford Royal Commission. During the hearings our respective roles were also totally different. At the end of each day Fife-Yeomans was obliged to reduce a day’s evidence into 500 words of ‘reader-interest’ material for the Herald and for the daily spot on Sydney’s radio 2UE, whereas Bromberger was spending countless hours pouring through over 1,000,000 documents in order to assist senior counsel Lloyd Waddy QC prepare his day-to-day cross examination. It was, of course, impossible for us to ignore the constant accounts of human tragedy presented by the more than 100 former patients and their families who came forward to give evidence at the hearings. They recounted the horrors of hal­ lucinations induced by the massive doses of the drugs they received at the hospital. We heard the soul-wrenching stories of guilt-ridden husbands, wives and parents who had taken their apparently mildly upset loved ones to the hospital on the recommendation of either Dr Harry R. Bailey or Dr John T. Herron, only to be later told that the patient had either died or been transferred, desperately ill, to Hornsby District Hos­ pital. We were daily presented with evidence which revealed an attitude to the practice of medicine by Drs Bailey and Herron, Dr Ian Gardiner and Dr John Gill, which would almost not have seemed out of place in a Gulag. For one period of more than six weeks we listened to some vi

INTRODUCTION

vii

50 former nurses at Chelmsford, who, with some stark excep­ tions, showed an almost total ignorance of the dangers associ­ ated with the use of the Bailey version of Deep Sleep Therapy. We heard Dr Herron describe his treatment for anorexia nervosa on a 13-year-old girl. She was nursed naked in a ward of similarly unclad adult males and females, and screamed in terror at being separated from her family (indeed her father was banned from visiting her), and at being placed in a darkened room. This young girl received 10 doses of electroconvulsive therapy (ECT) over a period of 14 days which Herron described as ‘perfectly appropriate’. We heard how Dr Gill and Dr Gardiner, neither of whom appeared to have any real understanding of the dangers involved, administered Deep Sleep Therapy, with tragic results to some of their patients. We heard the incredible story of Barry Hart’s attempts to pursue a damages claim against Dr Herron and the hospital, and his five-year campaign to persuade the healthcare author­ ities to institute disciplinary proceedings against the allegedly offending doctors. The remarkable irony is that his complaints about the failure of eye surgery, which were said to be indica­ tive of his delusional state, subsequently resulted in a substan­ tial out-of-court settlement by the surgeon’s insurers. At a different level the Royal Commission starkly demon­ strated that a trial hamstrung as it is by traditional rules of evidence and procedure, may be satisfactory as a method of solving individual disputes, but is totally useless as a vehicle for revealing or remedying societal inadequacies or injustices which do not bear precisely on the subject of the litigation. We watched and listened for weeks as an apparently emo­ tionless Dr Herron attempted to assert that every expert who had ever commented on Deep Sleep Therapy, whether over­ seas or in Australia, was wrong. And how, in spite of all the deaths and injuries, his continued use and defence of the treatment was medically sound. We witnessed counsel assisting, Brian Donovan QC, invite Dr Herron to produce any witness or any evidence that would medically justify the treatment provided, but for eighteen months not one scintilla of such evidence was brought forward. We witnessed the obvious confusion of the surviving patients as they were subjected to intense questioning about

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their pre- and post-Chelmsford medical histories, although they understood that the whole purpose of the Royal Com­ mission was only to investigate Deep Sleep Therapy at Chelmsford. Each of these instances, and many others, is itself sufficient to support a written work. By coincidence and over a cup of coffee, we discovered that we were both of the opinion that the main story was wider than an account of a litany of incidents of medical mismanagement and cruelty. Throughout the whole of the proceedings we were haunted by the shad­ owy and seemingly bizarre character of Dr Harry R. Bailey. How was it that in spite of their obvious hurt and confu­ sion, many of the patients who gave evidence to the Commis­ sion continued to be treated by Bailey for more than a decade after they left Chelmsford? How was it that the nursing staff, even on the few occasions that they questioned what was happening, were so overawed by his presence? How was it that the hospital owners, even in the face of constant adverse publicity, continued to trust ‘one of the most eminent psychiatrists in Australia’? How was it that Health Department officers were prepared to grant Bailey concessions not permitted to any other medical practitioner in New South Wales either before or since? Evidence was given to the Commission about how one patient reported the happenings at Chelmsford to her GP and begged him not to send anybody else there, but, within two weeks, he had referred another patient to Bailey, who treated her at Chelmsford and she subsequently died. Without any apparent supporting evidence of its success, magistrates sitting in New South Wales were prepared to accept the Bailey treatment for drug addiction, Deep Sleep, as an alternative to punishment. Bailey, who by any standards must be judged as having an unusual attitude toward women, is still defended by his former mistresses. Furthermore, he was able to turn to his wife in a moment of crisis even though they had been effectively separ­ ated for many years. It is, in our opinion, the remarkable paradox of Bailey which is the real story of Chelmsford. So powerful was his personality, that, even though for more than 10 years Bailey’s Deep Sleep regime was largely delegated to and administered

INTRODUCTION

IX

by Herron, other psychiatrists, who used the non-Deep Sleep wards at Chelmsford, were unaware that Herron treated his own patients with Deep Sleep. They were under the mistaken impression that Herron was Bailey’s lackey. What was it about Bailey that motivated him, trained as he was in psychiatry, to try to develop two procedures, psychosurgery and Deep Sleep Therapy, which required expertise in surgery and pharmacology far outside his own training? What was it that would drive a professional to place his whole future on the line to fight for the humane treatment of mental patients, yet, less than three years after that victory be committing acts of comparable callousness against his own patients? What was it about Bailey’s character or his standing in the general community that enabled some of his psychiatric colleagues to privately proclaim that he was a psychopath, yet take no steps to question his treatment methods? Why was a paper published in his name, in the prestigious The Medical Journal of Australia, which claimed a success rate of 99 per cent for an operation regarded worldwide as experimental? Why did a successful medical practitioner, who dreamt of establishing the perfect Deep Sleep clinic, and who had the means to do so, take only the most basic steps to realise the dream? And why did he claim to be its medical director when it remained unfinished and never admitted one patient? It will, of course, be impossible to produce a living portrait of Bailey without an analysis of Chelmsford and Deep Sleep Therapy, but we hope that by going beyond this we have avoided the obvious trap of presenting a one-dimensional response to what we see as a multi-dimensional personality.

[8 September 1985]

Sunday 3.30 pm.

This is a dying declaration, made in full awareness of its implications. It is my intention that the contents of my house at #10 Rogers Avenue, Haberfield, become the property of Ms Helen MacArthur of that address. She will notify my solicitor, Mr J. Levy of 14 Pope Street, Ryde. I agree to the request of my wife to transfer my property at 71-73 Piper Street, Leichhardt, to her, with the explicit understanding that this property will pass to my daughter, Pamina, at my wife’s death. I wish to thank my friends and dear ones for their forbear­ ance and kindness to me during this long period of suffering. I apologise to my patients for deserting them after so long. Let it be known that the Scientologists and the forces of madness have won. People should be warned that such cults are a danger to our society, and they should be crushed. Doctors like ... are equally to be abhorred. They are ego­ centric crazies almost as bad as the Scientologists. For the crown of our life as it closes Is darkness, the fruit thereof dust No thorns go as deep as the roses And love is more cruel than lust Time treats the old days with derision Turns our loves into corpses or wives And marriage and death and division Makes barren our lives. Harry Richard Bailey MB BS DPM MRANZP MRC (Psych.) Lond.

CHAPTER

1

EARLY PROMISE

Beside the body of a middle-aged man, found dead in his car parked on a lonely dirt track 50 kilometres north of Sydney, was a note (opposite). It marked the end of the life of Harry Richard Bailey, one of the best known medical practitioners in Australia. For the first 20 years of his professional life Bailey saw himself as a crusader for the rights of, and improved treatment of, the mentally ill. During this time he actively courted publicity, and revelled in the knowledge that he was regarded by the medical establish­ ment as a ‘stormy petrel’. The final 10 years of his life were spent in a professional bunker. During this time he was not only forced to defend his treatment methods and his medical ethics, but he was forced to fight for the very right to practise medicine. Bailey’s early life gave no indication of the turmoil and contro­ versy which were to be integral parts of both his personal and professional lives. He was born in Picton, a small New South Wales country town about 80 kilometres south of Sydney, on 29 October 1922. He was the eldest child of working-class parents, and his father, James Bailey, who was employed by the state railways, had risen to the rank of stationmaster. Life for young people in any small country town in Austra­ lia in the 1920s was isolated and insular and, unless interested in the rough and tumble of country life, it could be lonely and miserable. So it was for Bailey. More studious than his peers, he spent many hours by himself, avidly reading whatever was available. Quite early in his life it became apparent to all that he was a bright young man whose potential could not be realised within the confines of the limited education system available in rural Australia. His parents were not free to move to Sydney and were constantly being transferred to different railway facilities throughout the state. They decided that

1

2

DEEP SLEEP

Harry’s education was vital to his future, and that he should leave home. They arranged for him to board with two maiden aunts, and for him to attend a private school in Sydney. While such family dislocation must have been fairly traumatic it was by no means an unusual occurrence for country children at this time. The family was extremely proud of the fact that Harry was attending school in Sydney, and his brother Trevor and sister Nancy, although not given the same opportunities as Harry, held their older brother in awe. In later years Bailey expressed gratitude to his parents, but was anxious to embellish the facts. He took great delight in romanticising his early days away from home, always emphasising his recollection of his mother’s apple pies, which he sorely missed; he was, however, grateful for the opportunity to further his education, and expressed the opinion that the experience was a lasting lesson in personal independence. It appears that Bailey attended a Christian Brothers’ College in the eastern Sydney seaside suburb of Waverley. His 1962 entry in Who’s Who ambiguously reads ‘ed. CBC Waverley’. There is a well-known and prestigious Christian Brothers’ school at Waverley called Waverley College, yet there is no record of Bailey ever attending this school. The school historian at Waverley College, recalls that there was once two Christian Brothers’ schools in the suburb, but the second no longer exists. This is probably the school Bailey attended, but throughout his whole life he appears to have tried to create the impression that he had attended Waverley College. Although no records of Bailey’s secondary education exist, Bailey claimed to many people, including his long-time com­ panion, Jan Allan, that he was extremely successful at school. On completing high school in 1940, he began a science degree at the University of Sydney. All Australian universities at this time were fee-paying institutions, and Bailey found it difficult to find the money. He worked part-time at various pharmacies but, after about 18 months, he terminated his studies. For the next few years he took a number of jobs in pharmacies until in late 1944 he met his future wife, 23-year-old Marjorie Noonan. On 19 January 1945, following a courtship which lasted a mere three weeks, the couple were married. He began his medical studies the following year. Bailey received academic credit for his completed year of science and entered the second year of the medical degree.

EARLY PROMISE

3

Although older than most of his fellow students he was indis­ tinguishable from them. It was not until his final year that some of his many talents surfaced. With another student, Glen Duncan, he produced a collection of medical student jokes and sketches in which Bailey provided the artwork. These were distributed among their friends as Christmas pre­ sents with the covering note: Spirits Baileyi — Syrup Duncani For general Exhibition May be taken as an indication of incipient lunacy, but nevertheless wishing you seasons greetings His fellow students have little recollection of him, although one recalls Bailey attending a student dinner wearing a white tuxedo. This apparently left the desired impression because, when questioned over 40 years later if he could remember Bailey, this incident alone was instantly recalled. According to fellow students, such as his roommate, Dr John Greenaway, Bailey was extremely proud of his artwork and the following year he designed the sets and produced the programme for a medical students’ review entitled ‘The Guinea Pigs’. During his final year at medical school Bailey’s examination results indicated a hitherto unknown potential; he won first place in his class in both paediatrics and psychiatry. Bailey regarded this as proof of his superior intellect, and for the next 40 years took every opportunity to remind those who might doubt his ability that he had received these awards as a stu­ dent; so insistent was he, that in future judicial hearings col­ leagues such as John Herron and Evan Davies would feel it necessary to recall Bailey achieving these results. He never found it necessary to explain, however, that the Norton Man­ ning prize, awarded to the best psychiatry student, was actu­ ally a competition between only three students. He had also received considerable assistance from the young psychologist, Dr Davies, whom he met during training at Broughton Hall and who was to become a lifelong friend, in preparing and analysing the case study that won him the prize. His predilection for exaggerating even the most insignificant achievements is a recurring theme. In a formal statement, for example, made years later to a lawyer prior to litigation involv­ ing Chelmsford, ‘working as an assistant in a pharmacy’ was

4

DEEP SLEEP

transformed into ‘working as a pharmaceutical chemist’, leav­ ing the impression that he was qualified for this position. Part-time coaching in anatomy to physiotherapy students became ‘running a coaching college in anatomy and physiology for university students in medicine’. Bailey spent his first year as a medical practitioner in resi­ dence at Royal Prince Alfred Hospital, at this time the premier teaching hospital in Sydney. He had by now been married for over five years, but he carefully withheld this information from the authorities. There were no provisions made for mar­ ried residents and not even John Greenaway was aware that Bailey was married. Bailey’s activities certainly gave no indica­ tion that such was the case. He remembers Bailey as being older than the other students and recalls that he ‘appeared rather sardonically amused by the behaviour of children like me’. Mrs Bailey, in her evidence to the Chelmsford Royal Com­ mission recalled that it was during his year of residence that Bailey decided that his future lay as a medical specialist rather than in the field of general practice, and his success as a student reinforced this decision. The enormous post-war developments in the practice of medicine had opened the door for many young graduates to enter medical specialties. However, in Australia, there was a substantial network of establishment contacts that often deter­ mined which students would be the recipients of vital hospital appointments. Bailey’s social background did not automatically make him the beneficiary of this patronage, and this may have influenced his ultimate decision to specialise in psychiatry. Some of Bailey’s contemporaries have even suggested that hospital appointments sometimes depended on the applicant’s ability to represent the hospital at football. His wife Marjorie has described Bailey as being in constant poor health and as being anxious to pursue a career that did not involve him in the traditionally long hours of most areas of medical practice. Furthermore, psychiatry was slowly moving into the mainstream of the medical profession and thus there existed opportunities for someone such as Bailey: bright, ambitious, articulate and not forced to compete with others on terms other than ability. At this stage there was no great competition for psychiatric hospital positions but, even so, success still depended on support from those in control;

EARLY PROMISE

5

Bailey received encouragement from the two most highly respected psychiatrists of the time — Dr Cedric Swanton and Professor Paul Trethowan. They must have been delighted that someone with Bailey’s academic background showed an interest in making a career in psychiatry rather than the more fashionable branches of medicine such as cardiology and surgery. Dr John Herron, who spent almost his entire working life as an intimate colleague of Bailey, has said that Bailey and Professor David Maddison, who was to become an outspoken critic of Bailey, were the first two scholastically successful medical graduates to choose to specialise in the unfashionable field of psychiatry. They were the two people who brought good academic abilities with them to psychiatry. Prior to this ... many of the practitioners in psychiatric hospitals were not known for being the academics of the profession. Both Dr Maddison and Dr Bailey, who apparently both came to psychiatry at the same time, brought with them a new model — a model of academic ability, performance, questioning. Dr Maddison moved in the analytically oriented mode and became a professor of psychiatry and Dr Bailey was moving in the organic area, but they were two most impres­ sive and important men. Having decided to specialise in psychiatry, Bailey realised that he must obtain a graduate degree and began working towards his Diploma of Psychiatric Medicine. A requirement for graduation involved a student spending some time at a country psychiatric hospital, but Bailey was able to persuade the examiners that this requirement should be waived for him. A fellow student who was also enrolled in the programme recalls that ‘Bailey managed to con most people to get his own way’. Dr Jack Evans, another fellow student, who eventually suc­ ceeded Bailey as superintendent of Callan Park Psychiatric Hospital, spoke of his early impressions of Bailey: He was an incredibly bright fellow — there was no question

6

DEEP SLEEP at all about his level of intelligence, it was way out. But my view is that he was a psychopath in the sense of somebody who had a very faulty conscience. He regarded himself as a superior person. Sometimes he could manage to cover that up a little bit but he could never hide it for that long. He could get away with all sorts of things without any obvious feelings of guilt that you or I would feel.

Bailey began his graduate training at Broughton Hall Psy­ chiatric Hospital and, almost from the beginning, he was philosophically and intellectually attracted to a belief that mental illness involved physical abnormalities. This in turn led to the natural conclusion that any remedy should therefore be physically based rather than analytically treated. These beliefs were reinforced by the reported successes overseas of electroconvulsive therapy (ECT). While psychiatrists were unable to explain the reasons for the therapy’s success, it was clear that the electric impulses were in some way affecting that part of the brain which was causing the mental problem. This resulted in the conclusion that the procedure was the psychi­ atric equivalent to surgery, and encouraged people like Bailey to concentrate their efforts on the search for more physical cures for psychiatric problems. During Bailey’s training at Broughton Hall in the early 1950s, experiments were being carried out which involved the use of insulin coma therapy as a treatment for schizophrenia. Insulin coma therapy was a treatment based on the theory that induced coma was curative. At the time of its development the easiest way to induce a coma, which could be quickly termi­ nated, was to simulate the coma caused to a person with diabetes when the body receives an oversupply of insulin. This coma can be brought to an end by an intravenous injec­ tion of sugar in the form of glucose. It was this form of treatment that was to be the basis of Bailey’s lifelong belief in the miraculous powers of various types of sedation treatment. Bailey was horrified by the problems which insulin coma ther­ apy caused (not the least being the relatively high death rate), but he was convinced that the general theory was right, namely, that prolonged coma would alleviate many mental problems. In a lecture 20 years later he would say:

EARLY PROMISE

7

... if they went into irreversible coma, say, six hours, then you got them out again. When you woke them up, they were no longer schizophrenic. They had not a sign of the illness. No thought disorder. No disease of the brain. No, they had come back. Now this struck me one day . . . what is it about irreversible coma that is doing what the ordinary full coma treatment of one hour every morning is not doing? Even at this early stage in his professional life Bailey was prepared to venture into the medical unknown. While at Broughton Hall he endeavoured to set up a clinic which would concentrate on putting the patients into as deep a coma as medically possible. But as Bailey put it, ... all attempts to make an irreversible coma clinic met with stony opposition with everybody concerned, because, after all, they had the shit scared out of them with ordinary treatment let alone anything irreversible. Bailey’s obvious ability and his interest in institutionalised medicine resulted in his appointment, in 1953, to the position of assistant clinical director of the Division of Mental Hygiene of the New South Wales Department of Health. In 1954 he received his Diploma in Psychological Medicine. When he applied for a World Health Organisation travel grant he received strong support from Professor Trethowan and Dr Ian Fraser, the New South Wales Chief Medical Officer for Mental Health. In what the World Health Organ­ isation (WHO) now regards as a remarkable decision, the application was treated favourably and he became WHO’s first Australian Travelling Research Fellow. At that time it was contrary to the organisation’s policy to provide any funds for general travel grants, because any available funds were allo­ cated to Third World countries. As well as convincing WHO to give him a grant, Bailey had managed to convince the New South Wales health bureauc­ racy that great benefits to medicine generally and psychiatry in particular would flow from his trip. When Bailey and his wife were being farewelled at Sydney’s Kingsford-Smith Airport on 26 December 1954, Dr Fraser proudly announced that ‘he will

8

DEEP SLEEP

be blazing the trail of research into treatment of mental dis­ eases’. It is not surprising that with all this official support the local press carried front-page stories about the Baileys and hailed them as Australian heroes. Bailey planned to examine current neuropsychiatric research. This included electronarcosis therapy and recent improvements in the administration of ECT. He hoped to examine the worldwide progress of the electroencephalograph, a device which had been recently developed, and which was designed to measure the electric impulses in the brain, and ascertain whether it could be used in the treatment of mental illness and epilepsy. The worldwide interest in the treatment of mental illness had given rise to new theories in the design and construction of mental hospitals, psychiatric clinics and specialist clinics, so Bailey also planned to examine these, as well as specialised therapeutic methods and research techniques, including the new artificial hallucinogens such as lysergic acid diethylamide (LSD). Already Bailey was planning the opening of a specialised research unit and he hoped that his tour would arm him with sufficient information to enable him to present a detailed sub­ mission to the state government when he returned. It was the prospect of being responsible for the opening of a facility that was the equal of any in the world which excited Bailey, and also Dr Fraser. The failure of traditional treatment methods had encour­ aged many psychiatrists to hypothesise that the foundations of these methods were wrong, and during the 1950s Bailey was by no means the only psychiatrist who was convinced that success lay in physical rather than analytical psychiatry. The whole thrust of Bailey’s trip was directed toward an investiga­ tion of these physical treatments, with the ultimate aim that his planned research establishment would not be encumbered with any traditional treatment modules. Armed with his official introduction from the New South Wales Government and the World Health Organisation, Bailey was to spend the next 15 months travelling from country to country observing developments in psychiatric medicine. His programme was far too extensive to allow him sufficient time to participate in any research projects, but it did provide him with a worldwide network of contacts. The

EARLY PROMISE

9

Baileys visited practically every centre which was using some form of physical therapy. Each visit reinforced Bailey’s belief that he had not only found the secret of psychiatric medicine but that he could establish a treatment facility in Australia that would astound the medical world. The belief that the mind could be altered by the use of physical therapy was not restricted to those whose general aims were the alleviation of mental disorder. The immediate post-World War II period produced an outburst of inter­ national paranoia hitherto unknown. The rapid development of weapons of mass destruction had made it vital that each world power keep abreast with the weaponry of its perceived enemy, and as a consequence intelligence agencies reached new levels of importance. So-called ‘brainwashing’ became part of the general vocabulary, with the implication that thought pro­ cesses could be altered at the will of the controller. By 1952 the American Central Intelligence Agency (CIA) was actively involved in research into ‘mind control’ and psychiatrists were used to meet these ends. An internal memorandum of that organisation claimed that it should ‘get control of an individ­ ual to the point where he will do our bidding against his will, and even against such fundamental laws of nature as selfpreservation’. Bailey certainly liked to give the impression that his services were sought after by the CIA, but there is no evidence avail­ able which will confirm this. There is no doubt, however, that Bailey visited the clinic of Dr Robert G. Heath at Tulane University in Louisiana, USA. At this clinic Dr Heath, who, according to CIA records obtained under the US Freedom of Information laws, received funding from the CIA, carried out experiments on both animals and humans which involved the implantation of electrodes into the brain. The purpose of the electrodes was to try to locate those positions in the brain that were responsible for different emotional responses and this was done by passing an electric current into the brain via the electrodes. Heath selected patients from mental institutions, gaols and from among the terminally ill. Bailey was fascinated by these experiments, but the selection of patients was so bizarre and the dangers so great that, in a report written to the World Health Organisation, he commented,

10

DEEP SLEEP Heath has adopted a rather extremist position regarding the approach to mental illness, which does not permit of a balanced multi-disciplinary attack such as he proposes.

Years later Bailey made an astounding claim about Heath's research. In a lecture to the Chelmsford nursing staff he said that he saw Heath carrying out these experiments ‘on Negroes because they were cheaper than cats, and they were every­ where’. This would seem very unlikely, and if this was in fact the case, it is surprising that he did not refer to it in his report to the World Health Organisation which, as an organ of the United Nations, would certainly have been interested in this blatant breach of that organisation’s charter. One aspect of Heath’s experiments which appealed to Bailey was the attempt to find the area of the brain described by Bailey as the ‘pleasure centre’. Bailey was convinced that one of the reasons that individuals seek ‘pleasure’ is the need to stimulate this particular section of the brain. Bailey believed that if he could ‘unhook’ this part of the brain in those whose ‘pleasure’ was antisocial he could cure all forms of deviant behaviour. Strangely, Heath has no recollection of any visit from an Australian medical practitioner. In March 1955 Bailey spent three weeks at the University of Illinois. The CIA has admitted that throughout the 1950s large endowments were made by the agency to researchers at that university who were involved in testing LSD and an LSD antidote. In his report to the WHO Bailey wrote of his period in Chicago as being ‘most valuable’, enabling him to meet ‘many key workers in the field and to obtain much data which will be of use . . .’ Perhaps it is no coincidence that when he returned to Australia, Bailey carried out some ad hoc experi­ ments in which, along with 15 volunteers, he took LSD, claiming that he was testing this drug as a potential treatment for schizophrenia. The CIA was also funding a series of experiments which were being carried out at McGill University in Montreal, Canada. These experiments involved the use of heavy sedation in conjunction with electroconvulsive therapy. The purpose of these experiments was to test new methods of ‘brainwashing’ and the research leader was an extremely well-known and highly respected psychiatrist, Dr Ewan Cameron. At various times during his career Cameron was the president of both the

EARLY PROMISE

11

Canadian and the North American Psychiatric Associations, while at the same time he was the leader of the research team that was responsible for these experiments. They were carried out on patients without their knowledge or consent, and in 1988 the CIA admitted that this was the case and ordered that $750,000 be paid to seven patients who had been used as ‘guineapigs’ in this project. Bailey’s precise connection with these experiments was for many years the matter of some conjecture. His enigmatic responses to questions about his CIA contacts, and the bizarre nature of some of his treatments fuelled speculation, but any direct evidence is not available. It is clear that Bailey visited Montreal, but it would have been contrary to his character not to publicise any relationship he may have had with someone as highly respected as Cameron. The fact that Bailey adopted a treatment similar to that used by Cameron may also be coincidental because variations of the Cameron procedure were being tried at other institutions. From Montreal the Baileys travelled to London, and there Bailey witnessed for the first time a genuine attempt to use heavy sedation as a therapeutic tool. Dr William Sargant, a highly respected London psychiatrist and a friend of Cameron, was attempting to discover whether or not pro­ longed deep sedation could assist in the management of any intractable mental diseases. Sargant was in the second phase of his investigations: prior to World War II he had treated a number of patients using his deep sedation but after the deaths of two of them he terminated treatment. Following a consultation with Dr Harold Palmer, a well-respected London physician, Sargant realised that there were inherent risks in the treatment, but he also realised that these could be minimised provided the patient was not kept ‘asleep’ for periods longer than a few hours; that the patient was woken regularly for meals and toileting; and that some form of exer­ cise was incorporated into the programme. At this stage Sargant had not carried out any studies that would verify the general theory of the benefits of this form of treatment, but Bailey was already convinced of its merit. To Bailey, the foundation of the treatment was absolutely sound, especially as it accorded with his general belief of the physical base of psychiatric illness. ‘Rest’ was, and still is, the standard treatment for many ailments. To Bailey the logic was irrefut­ able: if damaged muscles and broken bones could be restored

12

DEEP SLEEP

by temporarily terminating their use, surely a ‘restless’ brain could be restored to equilibrium if, in Bailey’s words, ‘it could be turned off. This seemed to Bailey to account for the appar­ ent success of the insulin coma therapy he had witnessed during his training at Broughton Hall. Even at this early stage Sargant’s theories had not met with widespread acceptance, and it appears that Sargant was delighted by the enthusiasm shown by Bailey for the new treatment. Both in his own textbook, The Physical Methods of Treat­ ment in Psychiatry, and in his article published in 1972 in the British Journal of Psychiatry, Sargant described the problems inherent in the treatment. He warned about the dangers of temperature fluctuations and pneumonia; he emphasised the need for constant exercise for the patient; and suggested the patient be awakened for meals. So it is clear that Sargant was well aware of the dangers and difficulties that keeping humans in a state of near coma for prolonged periods created. Bailey claimed that Sargant discussed these dangers with him. Yet, at a later stage, Bailey appeared to reject these warnings — with drastic results. Bailey reportedly took great pleasure in explaining to his future colleague, Dr Herron, that Sargant wasn’t prepared to subject his patients to the same depth of sedation as was he, and because of this Sargant’s results were inferior. The two men remained in constant contact for almost 30 years, and a nurse at Chelmsford during the 1970s, Rosa Nicholson, recalled that Bailey often spoke of the competition between them to see who could keep their patients in the deepest coma without killing them. (It was probably Sargant’s failure to support Bailey when his treatment was being chal­ lenged that finally persuaded Bailey that his professional career was at an end.) It was inevitable that the touring couple should visit the research unit of Professor Lars Leskell at the University of Lund in Sweden. Leskell was a pioneer in brain surgery, and at his clinic he used both electrodes and lasers. Again, the use of surgery as a method of treatment for mental illness presup­ poses that the cause of the illness is ‘physical’ and that the problem can be alleviated if the ‘damaged’ part of the brain is excised. Leskell’s work concentrated on the two vital aspects of brain surgery: finding the offending part, and removing it without damaging other healthy parts. Although Bailey had

EARLY PROMISE

13

had no formal training in surgery, apart from that taken by all medical students, he was accepted into the ranks of the spe­ cialists at Lund. Bailey’s sharp mind enabled him to cover up any lack of technical knowledge and he was able to convince people that he knew more than in fact he did. A lifelong friend would later comment, ‘He would become an expert simply because he had met somebody. He had supreme selfconfidence.’ The two areas of psychiatry that fascinated him most required detailed knowledge of pharmacology and sur­ gery — and Bailey had only limited knowledge of both. It would appear that at least part of Bailey’s tragedy was caused because he overlooked these limitations.

CHAPTER

2

RETURN AND GLORY

The immediate post-war period saw the emergence onto the world stage of many hitherto insignificant nations. The estab­ lishment of the United Nations gave all member states a mea­ sure of equality, so small countries such as Australia were anxious to justify this new-found status. How better to do this than by producing the ‘world’s best’? The selection of Melbourne as the first city in the Southern Hemisphere to host the Olympic Games gave Australia new pride, but there still remained an inherent national insecurity. Training in all professions was not regarded as complete until graduate studies had been successfully undertaken overseas and a steady stream of aspiring medical specialists travelled to the United Kingdom in order to gain admission into a Royal College. Progress in academia was almost out of the question unless a graduate degree from Oxford, or Cambridge, or, to a lesser extent, one of the prestigious United States universities, was obtained. Some of Australia’s most brilliant creative think­ ers and performers were to discover that success at home depended almost entirely on success overseas, but, once this was achieved, lasting fame was guaranteed. It was into this atmosphere that Bailey returned to Sydney, early in 1956. A brilliant self-promoter, he referred to the famous centres, hospitals, and universities that he had visited, as though he had been employed by them as a visiting member of their staff. Both his very brief visit to the Mayo Clinic, one of the most famous medical establishments in the world, and to Lund University, the most modern centre for brain surgery, were singled out by him for a specific mention in his Who’s Who entry. The brevity of the entries in this publication allowed Bailey to give the impression that he had received the international recognition as a medical researcher that his apparent appointments at these institutions would indicate. In reality this was not the case: the ambiguity of the entries 14

RETURN AND GLORY

15

resembled the ambiguity of his entry regarding his implied attendance at Waverley College. Bailey intuitively knew how to ‘name drop’ in such a way as to gain maximum benefit from it. Australians of the 1950s were prepared to accept people at face value. This meant that claims of achievements, made by self-promoters like Bailey, were rarely, if ever, challenged. Thus it is not surprising that Bailey, on his return to Australia, should be lionised by the press. At the same time, politicians who thought that being attached to a star might be politically worthwhile were happy to allow themselves to be persuaded by his eloquence. If points are to be given for those personal attributes which, at least on the surface, measured a star, Bailey had them all. He was now in his mid-thirties, articulate and forthcoming. His physical appearance resembled that which was almost univer­ sally portrayed as the ‘ideal’ psychiatrist. Tall, dark, with pierc­ ing brown eyes, and wearing a goatee beard, he gave to some the impression of being a latter-day Sigmund Freud. Even today medical practitioners rarely give interviews unless they have been responsible for some outstanding dis­ covery, but Bailey was different. Those who had helped spon­ sor Bailey’s trip overseas were anxious to put Bailey before the public, and Bailey was eager to comply. He returned to Aus­ tralia amidst a blaze of publicity equal to that of his departure. While in reality Bailey had done little more than spend 15 months touring the United States, Canada and Europe, his well-publicised welcome home gave the impression that he was now an Australian medical practitioner who had earned a worldwide reputation. Yet he had researched nothing, he had written nothing, he had invented nothing, indeed he had only practised medicine for a mere four years. All he seemed to have done was create a network of contacts. But, remarkably, he had established a reputation for brilliance that was to last for almost 30 years. On his return Bailey submitted his plans for a specialised psychiatric research unit to the New South Wales Govern­ ment. He had been fascinated by the surgical unit he had visited at Lund University, and submitted that a similar but more adventurous unit should be established in Sydney. In Australia, as elsewhere around the world, the problems of mental illness and its treatment were finally gaining public attention. The issues surrounding the care of the mentally ill

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were beginning to be taken up by interest groups, politicians and the media. As the success rate of treating the mentally ill at this time fell far below that of other areas of medical practice, Bailey’s submission, offering as it did the hope of ‘cures’ for mentally ill patients, fell on fertile ground. Surely, he submitted, brain surgery must be part of the answer. All that was required was that technical procedures be sufficiently refined so as to eliminate the horrendous problems caused by such imprecise operations as pre-frontal lobotomies. What is astounding is that Bailey, who had no specialist training in surgery, should be accepted by the New South Wales Government as someone qualified to make such a sub­ mission. The explanation may be found partly in the person­ ality of Bailey himself. Dr Richard Mulhearn, who was subsequently to be a medical registrar at Bailey’s research unit, recalls that ‘Bailey was a handsome and gracious man who was able to put a view that would make thinking men and women believe that he should be believed’. Bailey submitted that the government should fund the establishment of a department he called the Cerebral Surgery Research Unit (CSRU), and employ him as its director. Before Bailey left Australia, Dr Fraser, his immediate superior at the Division of Mental Hygiene, had indicated to Bailey that he would support an application for a worthwhile project, so Bailey complied. Emphasising the unique nature of the project and the substantial kudos that the government would gain from its creation, Bailey’s salesmanship was brilliant. In a medical environment that was deficient in many areas, especially in the provision of basic psychiatric services, it was surprising that Bailey’s scheme received consideration at all; but that it received funding to the tune of one million pounds, a staggering sum in 1956, further indicates the skill of Bailey’s salesmanship. At the same time, however, it must be acknowl­ edged that giving Bailey a grant was politically useful to the government. It allowed the government to be seen as forward thinking and supportive of bright young men who were trying to advance the frontiers of medical research. The general plan was to set up a 20-bed unit in which all the worldwide surgical developments that Bailey had wit­ nessed on his tour would be incorporated under the one roof. Having received approval for the project, Bailey then pro­ ceeded to confirm delivery for equipment he had tentatively

RETURN AND GLORY

17

ordered while overseas. It would have been normal procedure for the innovative research and surgical equipment that Bailey was importing for his unit to be situated within the neurologi­ cal department of Royal Prince Alfred Hospital, the teaching centre for neurology, but instead it went straight to Bailey. This created enormous animosity between Bailey and the neurological specialists, but even so, they had nothing but admiration for the equipment and the general set-up of the CSRU. So advanced was the equipment imported for the unit, that over 30 years later some of it was still in use. It seems that Bailey may have carried too far the carte blanche in spending that the government had allowed him. He fitted fly-repellent tiles in the operating theatre — where there were no flies — for no other reason than they were the best. He installed a ‘magic eye’ door at the entrance to the operat­ ing theatre, neglecting to take into account the fact that dis­ turbed patients often wandered past, set off the opening device, and walked into the middle of an operation. He intro­ duced an elaborate intercom system which not only enabled the director to communicate with the staff throughout the hospital, but also enabled him to eavesdrop on any conver­ sation which might be held in any room in the unit. The intensive care ward was the most up-to-date available. Patients were wired up and connected to a master circuit, which in turn was connected to a panel situated outside the ward. This enabled the nursing staff to monitor simulta­ neously the vital signs of all the patients who were in the ward without actually having to enter the ward. Unlike any other psychiatric facility, the windows of the unit were not barred but were made of armoured glass, which Bailey described as being ‘anti-suicide’ windows. Bailey’s own office was equipped in a manner that would have satisfied the ego of a business tycoon. His desk was kidney-shaped, with drawers carefully made so as not to inter­ rupt the sculptured line of the table. A secret drawer was installed where he could put the pistol he kept on hand, and which he used when he visited his gun club. Also hidden in the desk was a mini tape-recorder which could be activated secretly by pushing a button on his desk. It was impossible to enter the office without permission. The door remained constantly locked and could only be opened if whoever was sitting behind the desk pressed one of

18

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the three buttons which had been installed to respond to any knock. A knock on Bailey’s office door would result in a flashing light that would show that the visitor could enter, that the director was engaged, or which would direct the visitor to pick up the special telephone that was connected to Bailey’s office. The CSRU was officially opened in 1957 by NSW Premier Cahill. The grand plan for the CSRU was that it carry out research into brain function, neurochemistry, brain surgery, psychosurgery, and other forms of psychiatric treatment. Having been appointed as director, it was obvious even to Bailey that he needed professionals with expertise beyond his own to ensure that the unit justified its existence. Bailey attracted to the unit such people as John Dowling and Stuart Morson, both prominent Australian neurosurgeons. He also offered a position to a Canadian, Dr Frank Irvine, who declined. (Irvine later wrote a leading and controversial text on psychosurgery entitled Aggression and the Human Brain. It was the appearance of this work which inspired Bailey’s suc­ cessor at the CSRU, Dr John Sydney Smith, to organise a seminar in 1974 into the status of psychosurgery.) Bailey also appointed an enthusiastic young psychiatrist, Dr John Herron, who was to remain a loyal colleague, and who would subse­ quently adopt many of Bailey’s more extreme ideas and use them on his own patients. It was imperative that the unit have access to a psychologist who could carry out pre- and post­ operative brain function tests on patients. Bailey appointed Dr Evan Davies, the psychologist who had assisted him to win the prize in psychiatry at medical school. Bailey saw himself as captain of the team, and long after his affiliation with the CSRU had ceased, both Herron and Davies continued to describe themselves as members of his team. The expenditure of such enormous sums of money needed some public justification, and Bailey was ready to oblige. He described, for example, the administration of new drugs which would drive patients temporarily insane, a procedure used to help locate the cause of mental illness. In the numerous speeches and interviews he was asked to give he emphasised the need for research into mental health by reporting that ‘schizophrenia was the largest social problem in the com­ munity’, and that it ‘struck down two to three youngsters in New South Wales daily’. He further claimed, in a speech to a

RETURN AND GLORY

19

Sydney Rotary Club luncheon, that schizophrenia had crip­ pled the lives of 100,000 people in the state. The text of this speech, given in 1958, was reported in detail in the Sydney Morning Herald. In a media report he explained his attempts to induce schizophrenia by administering to himself and 15 volunteers a ‘wonder’ drug called LSD. ‘In less than five minutes after the injection of these drugs you suffer all the delusions and hallu­ cinations that beset the unfortunate schizophrenic. You look at a light and it turns into a palm tree. The drab walls of a room glow with beautiful colours. You hear voices, see visions, and suffer the tortures of knowing you are no longer in con­ trol of your own mind.’ Bailey’s willingness to subject himself to the same traumas as his patients in order that he could better understand their problems, stamped him, in the eyes of the public, as a dedicated crusader. This, coupled with his apparent deep understanding of psychiatric medicine, seemed to convince this audience, and others, that here was a young doctor at the pinnacle of psychiatric research. Bailey also described how it was now possible, because of the sophisticated equipment and unparalleled expertise gath­ ered at the CSRU, to carry out surgery on the brain that had hitherto been impossible. He explained that once the portion of the brain that was responsible for the unwanted behaviour was located, it was now possible to insert a fine tube into the brain itself. ‘This can be done within one-fiftieth of an inch without damage to the nerve cells. We can thread the elec­ trode, a piece of fine stainless-steel wire plated with gold down the tube. It can be left for some time to measure the electric currents produced in the depth of the brain.’ An eager public was told how these new operations would help to reduce the apparent increase in juvenile delinquency, and also how the introduction of a procedure called ‘deep freezing’ would enable safe operations to be carried out to reduce the incidence of epilepsy. While the response of the general public and the press to Bailey’s psychiatric revelations can best be described as wideeyed, many of his colleagues were both embarrassed and furi­ ous. Embarrassed, because many of his assertions were either untrue or as yet unproven, and furious because he was por­ traying himself as an expert in an area in which he could only best be described as an amateur.

20

DEEP SLEEP

It was during this period that the rift between Bailey and the other leading young psychiatrist of the time, David Maddison, became apparent. Although both men were follow­ ing the same career path (there is evidence that they had met during training at Broughton Hall and had then got on quite well), their approach to their work was diametrically opposite. Maddison was cautious, meticulous and academically honest; he was to become one of the most highly respected medical academics that Australia has known. He would not tolerate slipshod work nor could he accept the need for gross over­ statement. Bailey, on the other hand, in his speeches and public presentations showed signs of professional sloppiness, and seemed prepared to use unsubstantiated statistics for apparent dramatic effect. Not only did Bailey’s personal relationship with Maddison deteriorate, but Bailey became increasingly isolated from his fellow psychiatric practitioners. Dr Herron put the start of Bailey’s professional isolation at the inception of the CSRU, although he asserted that he is unaware of the precise reasons for it. With hindsight the reasons would seem obvious: while envy and jealousy certainly played a part, there was justifiable annoyance at the fact that Bailey, who had as yet achieved little in scientific practice, should have access to a huge pool of funds, while others, who had devoted their lives to public service and research, should be unable to tap into the same source. What further infuriated other members of the profession was that the CSRU, with advanced technical resources and all the Bailey ballyhoo, was not actually carrying out its mandate. Dr John Sydney Smith, who succeeded Bailey as the director of the unit, told the Chelmsford Royal Commission: When I took over it was a very large unit. I think we had 57 beds and almost as many staff. It was extremely inef­ ficient. It had its own operating theatre, its own radiological theatre — a very sophisticated one — and yet the number of operations was approximately one a month. The number of intensive radiological investigations was very small and did not warrant the facilities we had. Secondly, it was cut off from a teaching hospital. We felt it would not survive outside a teaching hospital environment and that we could cut costs very dramatically by utilising the facilities of

RETURN AND GLORY

21

teaching hospitals, such as operating theatres. Not only was the CSRU cut off from the various teaching hospitals throughout Sydney, but Bailey took active steps to ensure that the facilities at his unit were not used by medical practitioners based at any other establishment. While it is possible to criticise Bailey for his failure to engage in any rigorous research, particularly as he had been appointed the head of the most expensive medical research unit in Australia, he did have a genuine interest in the use of electronics in medicine. Electroconvulsive therapy had long been administered by machines which, according to Bailey, were ... twice the size of [a] table, twice the height and ... wide, wheeled in by two nurses, on huge trolley wheels, all white metal, huge dials on top, big handles, like an X-ray console. And you know it scared the living daylights out of people; it used to scare me even. With Professor Trethowan, Bailey designed a machine which was aptly called a Miniature ECT Apparatus or Minecta. The machine was small, easily transportable and, at Bailey’s insistence, incorporated what was called a glissando. The theoretical basis for the adoption of glissando was that, within the fraction of a second that it took for the electric current to produce the electric shock associated with electroconvulsive therapy, there should be a gradual increase in the current rather than a sudden introduction of the peak amount. Dr Ian Gardiner, who for over 10 years administered ECT for Dr Bailey, described glissando as ‘a term used to describe a gradual increase in current up to a maximum. It reduces the abrupt onset of the tonic contraction of the seizure and was used before the days of muscle relaxants.’ The notion that it was possible to incorporate into one machine a doublebarrelled function, was something that Bailey, with his interest in electronics, would have found irresistible. However, by the time he had become professionally involved in the administra­ tion of ECT the development of short-acting anaesthetics had eliminated the problem that ‘glissando’ was supposed to solve. Yet Bailey persisted in the use of glissando as a substitute for

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DEEP SLEEP

anaesthesia, proclaiming its benefits even in the absence of any research data, and based solely on his own limited understand­ ing of the underlying theory. Some years later, he approached the chairman of Amalgam­ ated Wireless Association (AW\), Sir Lionel Hooke, and per­ suaded him to produce the prototype of a new Minecta built entirely to Bailey’s specifications. The only precondition imposed on Bailey was that he undertake a long-term research project. The purpose of this project was to accurately measure the benefits of the new Minecta compared to other commer­ cial machines. Bailey agreed, but never complied. He contin­ ued to use the new machine, claim credit for its invention, assert its superiority over other machines, yet made no attempt to verify his claims. Indeed, contrary to Bailey’s assertion that these machines were used in all hospitals throughout Austra­ lia, only one machine was ever built. In fact, the effect of the machine that Bailey designed may have been the reverse of what was intended. With conven­ tional ECT machines the administration of the electric cur­ rent resulted in immediate loss of consciousness and so in no resulting awareness of the treatment. The use of the glissando, however, meant that the patient did not receive the full impact of the current at the outset, and consequently may not have been rendered instantly unconscious. This supposition is somewhat supported by the report of patients who claim that they recall seeing flashes and bright lights and who remember feeling extremely distressed immediately prior to receiving ECT. It was with this rather dubious record of achievement that Bailey, in 1959, applied for and won the position of medical superintendent of Callan Park Psychiatric Hospital, in the grounds of which the CSRU was situated.

CHAPTER

3

CALLAN PARK — LOSSES AND GAINS

For hundreds of years the provision of mental health services has caused problems for governments throughout the world. The cost of maintaining public mental health services has always been high and, apart from keeping the mentally ill out of sight, the effectiveness of mental health institutions is still limited, although improved by the relatively recent discovery of psychotropic drugs which have the effect of reducing gen­ eral psychiatric symptoms. The complex and uncertain nature of mental illness has always been reflected by the response of both community and government to those who suffer from it. The provision of mental health services has never been regarded by politicians as a great vote winner. Consequently, the needs of the men­ tally ill have often been put aside in favour of those issues which politicians consider will produce a greater political return. The history of the treatment of mental illness shows that at various times sufferers were either feared or pitied, and the treatment provided to them reflected the current medical thinking. Until recently there has been one recurrent theme: irrespective of the prevailing medical opinion, ‘lunatics’ must be kept apart from the general population. Logically, once this theme becomes the basic premise upon which services are organised, there must follow a heavy emphasis on custodial care. It is not therefore surprising that in the nineteenth century there should be built enormous fortress-like asylums designed to ensure that the mentally ill were kept well away from the general public. In Australia the provision of mental health services is the responsibility of the individual states, and, by 1960, the largest psychiatric hospital in the country was situated at Callan Park 23

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in Sydney. Callan Park was originally a branch of the Gladesville Mental Hospital, and its physical construction is indicative of the official attitude towards the mentally ill at the time it was built in the 1890s. Callan Park is constructed from large bluestone blocks and situated in a huge parkland. At the time it gave the casual observer the impression of being some type of penal institu­ tion and, as a matter of reality, once any individual had been involuntarily admitted, it was often the case that a lifetime of detention could follow. The continued lack of community and government support over a period of more than 50 years was reflected by the overcrowded and dilapidated state of Callan Park. Originally designed to house between 400 and 500 inmates, its total population in 1960 had risen to 1783. Areas which at the time of its opening in 1897 were designated as corridors were by this time converted into dormitories. Inmates were forced to sleep in rooms so crowded that the beds touched each other, and the sanitary conditions approximated those which could be expected in the Third World. There were open toilets, and patients were expected to do their own washing at a tap situated over a stormwater drain. Physically the buildings were in a desperate need of refurbishment. Paintwork was peeling, dirt had become ingrained in windowsills and walls, and patient amenities were almost nonexistent. The treatment of the mentally ill not only lacked com­ munity and government support, but historically it lagged behind the work carried out in other branches of medicine. Long after treatment such as cupping and leeching were seen as manifestations of medical ignorance, cold water hosing was seen as part of the psychiatrists’ armoury. At various times psychiatry seemed to have promised so much but it had deliv­ ered little. The struggle for respectability was to some extent hindered by the innate difficulty that psychiatrists had in providing a satisfactory definition of mental illness, and it was not uncom­ mon to see psychiatrists portrayed as figures of fun or evil in popular plays and comedy productions. Bailey’s decision to enter the ranks of psychiatry, therefore, was unusual. His public image gave him immediate credibility and he revelled in the fact that whatever he had to say on the subject of psychiatry was given great weight. Unlike most

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25

other medical practitioners it seemed he needed no encourage­ ment to appear in public to expound on his adopted specialty. His appointment as the director of the CSRU clearly gave him the image of being in the forefront of psychiatric research in Australia, and his further appointment as medical superin­ tendent of Callan Park in September 1959 placed him in day-to-day contact with the provision of mental health ser­ vices. At first glance it is difficult to explain why Bailey should wish to take on this extremely onerous, largely administrative task. Until this time he had always declared an interest in research, and it was probably clear to him that this appoint­ ment would effectively put an end to that facet of his pro­ fessional life. In retrospect the reason may not be so difficult to find: although Bailey enjoyed being seen as a scientific pioneer, he had not displayed the temperament to engage in the long­ term projects that are an integral part of medical investiga­ tions. He liked power and as the superintendent of Callan Park, as well as the director of the CSRU he had effective control of the provision of mental health in New South Wales. Prior to his appointment Bailey had hardly ever set foot into the main hospital at Callan Park, but once he did he was in immediate conflict with his bureaucratic and political masters. It would have been impossible for any enthusiastic psy­ chiatrist not to have been astounded and dismayed by the dreadful state of affairs that existed at the hospital. Bailey was so scandalised by the quality of care offered, the general atti­ tude of the staff, and the physical conditions which prevailed, that he encouraged staff members to bring their complaints to him. Drawing on all the material he received, he filed a report to his employer, the Public Service Board. The report was dated 7 March, 1960, and in it he claimed that many of the staff at Callan Park were ‘sadists, criminals and alcoholic psycho­ paths’. He supported these allegations by listing a number of specific instances: ... patients often died unnoticed, and before a medical officer was called the body would be put into a bath of warm water in an attempt to demonstrate that the death was recent. On one occasion a dead body was strapped to the back of

26

DEEP SLEEP a motorbike and, in order to win a bet, the body was driven around the grounds of the hospital before being deposited in the morgue. Patients were subjected to a practice called “dusting the ceiling”. The patient would be wrapped in a blanket, thrown into the air and then allowed to fall back onto the floor. Patients were “towelled”. This involved the partial stran­ gulation of the patient by twisting a towel around the patient’s neck. Patients were “worked over” wherein they were kicked and punched while they were restrained in a straight jacket. Most of the nursing staff were involved in a wellorganised scheme of pilfering from the hospital’s kitchen.

Bailey claimed that between 10 and 15 carcasses of mutton and one carcass of beef had been taken in one haul; that rice, canned and dried fruit, salmon, baked beans, butter and eggs were stolen on a weekly basis. He claimed that between 20 and 30 gallons (80 to 100 litres) of milk were taken each day, and he also claimed to have obtained a ‘shopping list’ belonging to one member of the nursing staff: Items such as socks, cardigans, blankets, soap, toilet paper, and other miscellaneous articles were also removed. Material worth thousands of pounds has been allegedly taken from the building, construction and maintenance store. His report also claimed that one particular charge nurse was an alcoholic, that the night staff spent most of their time carousing, and that one night nurse was, on one particular occasion, so drunk that she had to be restrained in a straight jacket. He asserted that a female nurse openly solicited sexual relations with male colleagues, and that a senior nurse not only failed to report these matters to him, but that he actively covered up incidents of assaults on patients and theft of their property. He complained that the administrative procedures were ‘laughable’ and that they made pilfering easy. Patients were poorly fed, poorly clothed, and received substandard treat­ ment from insufficient numbers of inadequately trained staff.

CALLAN PARK

27

Bailey concluded his report with: Generally it appears that this is a very corrupt hospital, with very little discipline or notion of ethics of psychiatric treatment . . . Staff openly flaunt their contempt for patient and administration alike . . . There are a certain number of well-motivated junior men and women, particularly those who have been through Gladesville training school. These people are retarded in their work, and openly opposed by the “old guard”. The most outstanding thing about it all is the attitude amongst the senior officers that “we know it goes on but there is nothing we can do about it”, or its corollary “catch one or two and it will settle down until the next time”. This later [belief] has been disproved recently when one nurse was caught leaving the hospital with six hams, several fowls, and two bags of vegetables in his truck. He was fined 40 pounds or 10 days’ hard labour. To the best of my know­ ledge this resulted in a cessation of activity within the hospital for three or four days. The most frightening thing of all is that brutality towards the patients goes on on a fairly grand scale. Bailey ended his report with what he saw as a solution to the problem. He recommended that the staff be supervised on a day-to-day basis by placing ‘dummy’ patients in the wards and ‘dummy’ employees in the kitchen. He recommended that all senior staff be replaced and that all charge nurses should be transferred to wards other than those in which they were currently working. He also recommended that there should be a series of ‘night raids’ during which an investigation could be made in order to catch those members of staff who were not carrying out their duties adequately. Finally he urged the Public Service Board to come into the hospital, break open all locked cupboards, including all private lockers, in order to find any stolen material that might still be on the premises of the hospital. Bailey sent his report to the under secretary of the Health Department, Mr J. D. Rimes. Mr Rimes passed it on to the chairman of the Public Service Board, Mr Wallace Wurth. From Mr Wurth it was passed to the Commissioner of Police,

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Mr Delaney. The police began an investigation into the allega­ tions, concluded that nothing was amiss, and handed their report to the Board on 25 May 1960. Following the police investigation, the Department of Health sent an inspector to Callan Park. He was joined in his investigations by the chief medical officer for mental health, Bailey’s old friend, Dr Ian Fraser. This investigation also found nothing which would substantiate Bailey’s allegations. Bailey was furious and decided to take the matter into his own hands. His meteoric rise to prominence had, to a large extent, been brought about by his skilful use of the media, and he was well aware of the use to which it could be put. He was also well aware of the fact that adverse publicity could moti­ vate governments to act. With this in mind he called a press conference. He detailed the complaints that he had made to the Public Service Board almost eight months earlier, knowing full well that his audience would react immediately. In October 1960 a series of articles appeared in the daily papers setting out the substance of Bailey’s allegations. He had been working in the public sector all his professional life and he must have been aware of the way in which public sector authorities would respond to his claims. The headlines of the Sydney Morning Herald on 29 October 1960 proclaimed ‘CALLAN PARK — ITS OBSOLETE SYSTEM BREEDS APATHY’. Then followed: If the beginning and end of Callan Park’s troubles were that sections of its staff were incompetent, dishonest and even sadistic, the task of Dr Bailey, who was appointed Medical Superintendent late in 1959, would be heavy indeed. But the staff situation is only one symptom of a more general condition at this mental hospital whose obsolete system of locked wards has bred apathy, dirt, and decadence ... he [Bailey] is resolved to give Callan Park its self respect. Almost immediately the Public Service Board announced that there would be an enquiry into the efficiency, economy, and general working of the Department of Public Health, with particular reference to Callan Park. Even had the matter stopped there, Bailey would still have been in conflict with his employers. He had broken the golden rule of public servants — never speak out publicly. He had

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29

also failed to realise that, although Dr Fraser had supported him in his rise to ‘stardom’, he could turn out to be a formi­ dable foe. Irrespective of the accuracy or otherwise of his allegations, Bailey had demonstrated that he was not temper­ amentally suited to work within the constraints imposed upon senior members of the public service. He had failed to realise that to ridicule a branch of the public service is to ridicule the government, and that even his apparent popularity could not withstand the onslaught that was to come. The Minister of Health, Mr Billy Sheahan, had been in the United States when the newspaper articles appeared. He would later claim that it was not until some weeks after his return on 29 November that he eventually saw a copy of Bailey’s original report. Sheahan was an experienced politician and he was sensitive to the political mileage that the opposi­ tion could gain from the report’s disclosures. He immediately brought the matter to the attention of the Premier, Mr John Hefferon. The Premier responded by announcing that the public service investigation would give way to a Royal Com­ mission. He considered that setting up such a Royal Commis­ sion was the answer to any claim that the government was covering up the state of affairs at Callan Park. He felt that the wide-ranging nature of a Royal Commission was appropriate for an investigation into the type of allegations Bailey had made, especially as this form of hearing is not restricted by the traditional laws of evidence. The only restriction imposed on a Royal Commission is that the enquiry must not go outside its terms of reference, but Hefferon announced that the terms would include both Bailey’s allegations and the provision of mental health services generally. The findings of the Commission were brought down by the Commissioner, Mr Justice McClemens, nine months later. He concluded that while Bailey’s allegations contained substance, many of the specific complaints could not be proved. He found that the staff had indeed attempted to prevent a thorough investigation of the hospital, and that they had tried to cover up any details that would tend to show them in an adverse light. As well, the Commissioner found that the kitchen staff had threatened to strike because the hospital administration was attempting to prevent pilfering. He further found that information of staff misbehaviour was withheld from Bailey, and that Bailey was partly correct when he

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claimed that the staff was corrupt, lacking in discipline, and devoid of ethics. He was not, however, prepared to make a blanket condemnation of the hospital: There are some areas of corruption as well as some areas of dedication. Some of the nurses are slovenly, careless, and have no real regard for their patients, but on the other hand, there are some who are well motivated and conscientious. He agreed that there was insufficient staff, and while he was prepared to find that staff supervision was lacking, he was not prepared to conclude that the accounting procedures, were, in Bailey’s words ‘laughable’. He was satisfied that there was wide­ spread theft from the hospital, but he formed the opinion that Bailey’s claims were exaggerated. He totally rejected Bailey’s claims about the mistreatment of dead bodies, although he was critical about the lack of procedures for the removal of deceased patients to the morgue. He considered that there was some evidence which led to a conclusion of instances of staff cruelty to patients, but it was not as prevalent as Bailey had claimed. The story about the drunken male nurse was found to be accurate. The Commissioner confirmed a submission that most of the problems that arose at Callan Park were brought about because of lack of adequate funding, and said, ‘In spite of attempts to better it since [1955], Callan Park is too big, too crowded, its standard of accommodation low, its emphasis mainly custodial; owing to lack of staff and amenities there is little treatment or rehabilitation.’ He referred to the older parts of the hospital as ‘dingy, depressing and demoralising’. He likened one part of the hos­ pital to a prison, and concluded that ‘there was no need to keep mental patients in squalid, depressed or crowded condi­ tions’. Mr Justice McClemens was by inference critical of Bailey. He found that the hospital lacked medical leadership, and he totally rejected Bailey’s suggestion that the problems could be solved by the introduction of a system of staff spies: ‘Problems at Callan Park present a challenge to medical and administra­ tive brains. These problems cannot be met without the pro­ vision of additional money.’

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31

The findings reflected badly on Bailey’s ability as a medical administrator and on bis sense of perspective, for many of the allegations made by him were rejected. It appeared that in some instances he had made no attempt to verify the accuracy of the reports he had received, and had often simply coloured the facts in order to draw attention to the situation. This enabled those individuals whom he had offended by publicising the whole matter to highlight his unsuitability as a leader. He had made a powerful enemy of the hospital staff, so much so that their legal counsel informed the Commission that it would be impossible for there to be ‘fruitful cooper­ ation’ with management as long as Bailey was at the helm. Mr Sheahan, smarting over the Commission’s findings, lost no time in identifying the culprit. Bailey had to go. He pointed to those aspects of the report that were critical of Bailey and he called for his resignation. Sheahan claimed that Bailey had bypassed official channels for his own ends, and criticised him for not going to the Minister with his concerns. He took great delight in November 1961 in tabling in parlia­ ment a public service document and as he did so, claimed: On the record shown in papers laid on the table in this House, the Public Service Board would not recommend Bailey as a person to be re-employed . . . According to the Auditor-General, Dr Bailey showed gross incompetence in the management and control of the fund into which he paid moneys that should have gone into consolidated revenue. He also ridiculed those who claimed that Bailey was being treated shabbily: This superintendent, whose heart was apparently bleeding for his patients, had his own office renovated at a cost of six hundred pounds and had six thousand pounds spent on the entrance while there was a bathroom in existence that was a disgrace . . . When I interviewed the superintendent and suggested that other work should have been done, what did he say? “I did some of the electrical work myself’. Imagine a superintendent engaged in that type of work when he should have been attending to his patients and to his administration.

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Bailey had expected that his stay at Callan Park would be lengthy, so he had begun renovations to the Gate House, the residence of the superintendent. Sheahan was irritated that the Baileys took so long to vacate the premises and wrote to them requesting that they speed up their departure. His anger and resentment is apparent in his demand that improvements to the residence made by the Baileys be left intact. Mrs Bailey recalled to the Chelmsford Royal Commission: He sent me a letter to please leave the cedar ceiling in that I put in the lounge room. I hope it is still there because it was very beautiful. I could not exactly take the ceiling down that the builders had put in. It was a government installa­ tion but the cedar was given to me by Ron Kessler of the Building Information Centre in Elizabeth Street. It was thumb cut cedar. The conflict made marvellous newspaper copy, and, not surprisingly given past performances, those reporting it depicted Bailey as the hero. Sheahan had a reputation for being a bully and great pleasure was taken in reporting his obvious discomfort. In its editorial of 13 September 1961 the Daily Telegraph protested: The resignation of the superintendent of Callan Park [Dr Bailey] will arouse public anger. It smacks too strongly of an act of reprisal for the reve­ lations of the Royal Commission on conditions at the hos­ pital . . . reform when it comes, will essentially be Dr Bailey’s achievement. The Sun hailed Bailey as ‘one of the country’s most brilliant research scientists. A . .. perfectionist... enthusiast... a man of many parts. A near genius . . . irreplaceable.’ The Commission’s findings and Sheahan’s heated response allowed the opposition party to force a debate on Callan Park in parliament. Sheahan, who had claimed to be unaware of the dilapidated state of Callan Park, had his attention drawn to an answer given by him to a question in the House about the state of Ward 7 at Callan Park. Sheahan had said: I must admit that Ward 7 is in a deplorable condition ...

CALLAN PARK

33

The worst types of patients are housed there, but the atten­ dants are doing a remarkable job with them ... I hope the old building will be pulled down at least before the end of next year. Unfortunately for Sheahan this reply was given on 2 December 1959, some four months before Bailey had writ­ ten his report. Sheahan, who had further claimed that he was unaware of Bailey’s report until November 1960, was also embarrassed to learn that its existence was common knowledge within the public service. Speaking in parliament a member of the opposition, Mr C. J. Earl claimed: The strange thing is that this document, marked highly confidential, was circulated around among a group of public servants but it was so confidential that the minister in charge of public health could not be told about it. Also speaking in parliament, the leader of the opposition, Mr Robert Askin, said that he was so scandalised by the unreasonable removal of Dr Bailey from the public health scene that, should the opposition be returned to government, he [Mr Askin] would take whatever steps were necessary to lure Dr Bailey back into the public sector. Despite this support, the aftermath of the Commission found Bailey the loser. He was seen by those who had sup­ ported him in the past as a traitor for breaking the public service’s code of silence. Both Sheahan and Dr Fraser had been directly involved in the funding of the CSRU, yet Bailey was now regarded by them not only as lacking in loyalty but also as nothing more than an opportunist. The animosity between Bailey and Sheahan continued for many years because Sheahan was extremely sensitive about rumours that Bailey had used his hidden tape-recorder to tape an interview he had had with Sheahan. One of Bailey’s closest friends recounted the meeting: ‘I suppose he thought Sheahan was probably a bit disturbed and he wanted some evidence that he was dealing with someone who was out of control.’ Bailey made no secret of the fact that he had a record of the meeting and frequently related that part of it which showed

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Sheahan to be a figure of fun: ‘There was a supply of silky underwear on the shelf ready for the female patients. Sheahan kept picking them up and throwing them at me one by one repeating, “I am the Minister, I am the Minister!” ’ The Callan Park affair forced Bailey to change his career path. Within the Health Department he had become persona non grata and, according to Mrs Bailey in her Royal Commis­ sion evidence, he was told that, even though he could not be dismissed, he could be sent to a country hospital. To Bailey this information effectively made him unemployable, and he immediately decided to leave the public service. Within the general community, however, and in the eyes of the press, he was regarded as a martyr. But there were many medical prac­ titioners who were not surprised that he should have run foul of the bureaucracy, and not a few who made no secret of their satisfaction that this upstart should have been shown for what they believed he was. Few people ever read the detailed findings of a Royal Com­ mission, so, in the absence of real knowledge, Bailey’s image remained untarnished. Irrespective of where the appropriate censure lay, the ramifications of Bailey’s report were to affect the future course of psychiatric practice in Australia. As a result, public mental health services were now in the public forum. Mental health legislation became the subject of legal and medical debate, especially as it applied to the involuntary committal to institutions of persons suffering from mental illness. The effect was summed up by Dr Richard Mulhearn, a neurologist who spent six months at the CSRU during Bailey’s tenure: ‘Bailey may have been bad, and he may have been mad, but he did more for the practice of psychiatry than anybody else in Australian medical history.’

CHAPTER

4

INTO PRIVATE PRACTICE

Bailey’s forced entry into the world of private practice created an unaccustomed void in his life. No longer was he able to expound his theories to the eager students who attended Callan Park as part of their medical training, nor was he any longer in a position to walk the corridors of power. There was nothing now to distinguish him from hundreds of other 40-year-old doctors who occupied suites in Macquarie Street. He was just another medical specialist whose success or failure in practice depended on whether or not general practitioners referred their patients to him. Bailey’s attitude toward those upon whom he was now rely­ ing was less than flattering. Far from believing that referral to him depended on proof of his competence, Bailey treated the whole episode as an exercise in marketing. Some years later he was to expound his theories about obtaining referrals from general practitioners to a young obstetrician and gynaecologist, Dr Jules Black: ‘Make them remember you!’ he told Black. ‘Use distinctive notepaper for your correspondence, have a flashy letterhead, and be sure that when they are trying to think of the name of a specialist, with the patient sitting opposite, your name comes to mind.’ Bailey used a special waxed letterhead and always signed his name in green indelible ink. He ensured that all his letters were stamped with eye-catching special-issue postage stamps. ‘It’s the fine details that make the difference,’ he said. ‘Make sure that you do not paint your rooms the wrong colour. Kentucky Fried Chicken outlets are painted [in a manner that] encourages people to buy and leave, whereas you want to create an atmosphere of calm.’ This attitude within a profes­ sion that prided itself in its understated conservatism could only be described as flamboyant. Bailey soon discovered that it was possible for him to spend the whole day within the four walls of his surgery speaking to 35

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nobody but his patients or his secretary. Private practice is a solitary life and not only did Bailey, whom Evan Davies has described as ‘a hospital doctor’, miss the continued pro­ fessional contact that hospital practice provided, but he had reached the stage in his professional life where he needed, and indeed expected, to be able to make decisions that were farreaching and important. Decisions about the size of his desk and the quality of his personal notepaper failed to satisfy either his ego or sense of professional hierarchy. Since the early 1950s every word he uttered seemed to be of interest to others, but now he was, comparatively speaking, professionally and personally isolated. Bailey’s entry into the world of private enterprise did not bring with it any of the traditional financial hardships that were the usual hallmark of such a move, except that he was forced, with his wife and his adopted 4-year-old twin daugh­ ters, to vacate the house in which they had been living in the grounds of Callan Park. The family’s departure from Callan Park in 1962 necessi­ tated the purchase of a house, and they moved into Piper Street, Leichhardt. Bailey saw this move as an opportunity to indulge his hobby, carpentry, and he began renovations. He was proud of his handiwork and, as with the practice of medicine, he was convinced that he could carry out all aspects of the renovations. This included electrical wiring and plumb­ ing, both activities that legally required licensed tradesmen. He was so sure of his ability as a builder that he undertook to construct the family swimming pool. The house at Leichhardt was built on a rock base and this meant that it was necessary to blast the rock in order to dig out the pool. Here Bailey proved the accuracy of a claim he had once made to Dr Mulhearn, that he could ‘get anything’. He illegally obtained a packet of detonators and proceeded to blast the rock, contrary to council regulations and their specific directions. Jules Black recalls an interesting Bailey dinner party: We had finished dinner, and it was about one o’clock in the morning. Bailey suggested that we should come outside because he wanted to show us something. He went into the garage and produced two detonators which he proceeded to set off. The noise was deafening, especially as it was late at night and everything was so quiet.

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37

When Bailey really got down to business and set about digging the pool he succeeded in blowing a hole in the sewage line. This he thought great fun and he was unconcerned by the serious inconvenience and expense it caused to others. The background of his entry into private practice differed markedly from almost all his colleagues. The Callan Park Royal Commission had reinforced his status as one of the best known psychiatrists in Sydney. To the chagrin of some of his fellow professionals (and now his competitors), his entry into private practice was described in parliament by the state leader of the opposition as ‘a boon to the private practice of psychi­ atry’. In a state where ‘advertising’ by medical practitioners was grounds for serious disciplinary charges, publicity of this kind was seen as taking an unfair advantage. There was resentment towards him and there seemed to be an attempt by his col­ leagues to ensure that he ceased to be placed before the public as an authority on all aspects of the practice of medicine. In May 1962 he was asked to address the Australian Archi­ tectural Convention, the topic of his paper to be ‘The Psy­ chiatrist and Architecture’. Bailey readily accepted, but was subsequently forced to decline. The chairman of the conven­ tion’s organising committee, Mr C. J. Farrington announced to the daily press that Dr Bailey’s forced withdrawal was ‘a ques­ tion of ethics’ and that ‘the Australian Medical Association asked him not to deliver the paper because he was in private practice’. The editorial writer of the Sydney Morning Herald was outraged and commented: ... members of the unenlightened public can only wonder what great principle of moral conduct the medical practit­ ioner Dr Bailey would have breached if his profession had allowed him to present a paper to the current convention of architects. The courageous and public spirited former medi­ cal superintendent of Callan Park is not the kind of man to say anything to corrupt architectural standards ... Interest is ... aroused by the fact that another psychiatrist, Dr John Herron, took Dr Bailey’s place to present a paper with precisely the same title. His employers, the State Psychiatric Service, evidently found nothing in this unethical ... the rule seems to have the purpose of preventing doctors from attracting patients by securing publicity for their activities.

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This type of public reaction to Bailey only caused his col­ leagues to harbour increased feelings of antipathy towards him, and reinforced their opinion that he was really not one of them. Yet while his forced entry into private practice may have caused him some emotional distress, it also opened up new opportunities. The Callan Park affair had shown that Bailey regarded the restrictions often imposed by bureaucrats, medi­ cal or otherwise, as being responsible for much unwarranted interference with his work. Private practice, however, is not only solitary but is largely unsupervised. No longer constrained by the restrictions of the public sector, Bailey was now in a position to test some of his pet theories. The attractions of power had, for the past few years, sidetracked him from becoming Australia’s leading psychiatric researcher, which he saw as his destiny. It is possible to deduce Bailey’s perception of psychiatry from his writings and from his comments to colleagues and patients. He seemed more than ever convinced that the human mind worked in a manner similar to that of other parts of the body and, there­ fore should be able to be ‘repaired’, when damaged, in a similar way. Advances in the administration of anaesthetics and in the anaesthetics themselves enabled surgeons to perform opera­ tions taking many hours, while the continued arrival on the scene of new ‘wonder drugs’ seemed to provide hope that within the near future all disease and malady would be wiped from the face of the earth. Why should not the same princi­ ples apply to psychiatry? It was inconceivable to Bailey that a problem might not have an answer, and that, if he put his own mind to it, he could not solve it. But in order to do this he needed room to move — and this could only come if he had access to a hospital. Working in a hospital in the public sector was out of the question, not only because of the animosity held by many in the profession towards him, but because only the practice of ‘conventional’ medicine was permitted. Bailey had something much more exciting in mind. As he was unable to pursue his interest in brain surgery without the assistance of a respected surgeon, he enlisted the aid of Dr John Dowling, one of the most highly respected neurosurgeons in Sydney, who had worked with him at the CSRU. Not only was Dowling a superb technician but he had access to the sophisticated

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39

surgical wards of Sydney’s Prince Henry Hospital. Bailey was not alone in his belief in the ultimate future of brain surgery, but he was in the minority in his belief that in advance of total mental breakdown, it was by prescribing drugs that the necessary relief could be achieved. For reasons that are not apparent, Dowling seemed to be prepared to carry out all of Bailey’s wishes with regard to the surgery, and over the next few years they were to be respon­ sible for more operations on the brain than all other medical practitioners in the country put together. Again for reasons which are not apparent, Dowling seems to have had a free hand in deciding whether or not to perform these relatively new operations. He also seems to have regarded himself as little more than the technician responding to the direction of the theoretician, and he made little or no effort to ascertain whether or not his handiwork was having its desired effects. Some of the patients who Dowling operated on cannot recall ever having met him. The second prong of Bailey’s psychiatric thesis involved the implementation of a modified version of Dr Sargant’s sedation therapy programme. This also required access to a hospital, but Bailey was well aware that no public hospital would be willing to allow him to subject patients to this treatment, so he began searching for a private hospital as a substitute. Fortuna­ tely for Bailey his receptionist, Mrs Audrey Church, told him that she knew of a private hospital that would be prepared to take his patients. Almost immediately Bailey sent his first patients to St Anne’s Private Hospital in the northern Sydney suburb of Killara. There are no medical records available which describe the precise nature of the treatment that was prescribed, but the owner/matron of St Anne’s, Mrs Clare Ray, had vivid recollections of it. She recalled that the first of Bailey’s patients was admitted to her hospital while she was overseas. On her return she saw sights that she had never seen before — patients asleep for days on end! Her medical training alerted her to the problems associated with the care of comatose patients, and she decided that her hospital, ill-equipped as it was for such patients, was not going to be used to provide a treatment which carried with it such obvious risks. Matron Ray found herself in what she saw as an untenable situation. As the proprietor of a private hospital she was

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anxious to keep her bed occupancy as high as possible, yet her professional training caused alarm bells to go off. The hierar­ chic structure of the medical world meant that, as a nurse, any challenge she might make to the nature of Bailey’s treatment would almost certainly meet with failure. She was well aware, however, that the continued use of the treatment would sub­ ject herself and her staff to situations that they could neither emotionally nor professionally handle. She decided to find a way to make Bailey leave. Instead of challenging Bailey either to his face or by consulting others, she developed a ruse to force him to leave St Anne’s. When­ ever Bailey or Mrs Church telephoned the hospital to arrange for the admission of a patient they would be told that there were no available beds. Although she did not know it, Bailey’s reaction to any hindrance to what he considered was his absolute right to treat his patients how and when he chose, was absolutely predictable. He would brook no interference from those he considered to be his intellectual inferiors, nor could he tolerate the uncertainty that Matron Ray was creat­ ing. Consequently, he decided that he must quickly find a new hospital. Bailey’s reaction to Matron Ray’s apparent interference was probably no different from that which would be expected from any other senior medical specialist. Within the public sector, the senior consultant was, within his own domain, all-powerful. The nursing staff were there to provide the ancil­ lary help but certainly not to make any independent judge­ ment of a treatment regime. Matron Ray was conversant with this medical self­ perception, although she thought that Bailey fitted into a dif­ ferent mould. She described him as a ‘bad man with a medical degree’, although it is impossible to know how much of this assessment is based on hindsight. Little did Matron Ray realise that she had discovered the best way to deal with Bailey. Whenever Bailey was faced with a bureaucratic obstruction he would ignore it. By doing this he forced whoever was creating the obstruction to make the next move. Only rarely was this next step taken, and consequently Bailey was invariably and tragically left to his own devices. Never one to acknowledge defeat, in whatever form, Bailey subsequently turned the story of his departure from St Anne’s to his own advantage. At a later time, when the morale of the

INTO PRIVATE PRACTICE

41

nursing staff at Chelmsford Private Hospital was at a low ebb, and they were having doubts about their ability to carry out Bailey’s sedation programme, he used bis departure from St Anne’s as a way of expressing his faith in them. He described Matron Ray as ‘notorious’ and explained that he had left St Anne’s because of ‘the failure of the hospital to meet the stringent demands I imposed upon it for the treat­ ment of my patients, as well as the failure of the owner to provide me with sufficiently trained personnel’. In light of what is now known about Bailey, Matron Ray’s account of his departure is to be preferred. The facilities at Chelmsford have been shown to be totally unsatisfactory for nursing comatose patients, and Bailey took no steps to ensure that adequate equipment and suitably trained staff were pro­ vided. He was prepared to allow that state of affairs to exist for almost 15 years. During his short stay at St Anne’s Bailey had managed to convince a dedicated nursing sister, Betty Shea, that his treat­ ment provided the ultimate salvation for many psychiatric patients. He also convinced her that it would be a medical tragedy if the ignorance of one hospital owner had the effect of preventing the development of his treatment. Shea, described by Bailey as ‘a lovely child’, ‘young’ and ‘blushing’, resolved to help him. Within a matter of weeks she had come up with a solution. She had found a 15-bed cottage hospital in Pennant Hills, another northern residential suburb of Sydney. It was called Chelmsford Private Hospital and had only been open for a few months. Fortunately for Bailey it was not providing its owner, Matron Elva Howard, with a satisfactory financial return. The prospect of having the best known psy­ chiatrist in the city sending his patients exclusively to her hospital must have seemed like manna from heaven.

CHAPTER 5

CHELMSFORD PRIVATE HOSPITAL

Bailey referred his first patient to Chelmsford Private Hospital in May 1963. The hospital was a far cry from the advanced technology of the CSRU. It was simply a suburban cottage situated in a Sydney dormitory suburb. Since it had begun functioning as a private hospital it had catered mainly to geriatric patients and was licensed ‘medical or post-operative’. In order to obtain a licence for these services a hospital needed only to provide basic nursing care and to comply with general requirements relating to cleanliness, kitchen facilities and general structural soundness. Bailey’s isolation from the profession at large meant that he did not have access to any of the better known private psychi­ atric hospitals and, at the same time, he hated the thought that he might have to comply with either medical or administrative requirements that might be imposed upon him by another medical practitioner. He was delighted that Mrs Shea had been able to find a substitute for St Anne’s, but he was aware that the hospital was neither adequately equipped nor suitably staffed to carry out any sophisticated therapy on his patients. Until this time Bailey’s whole professional life had been spent working in public hospitals, so he knew what medical safeguards were considered essential. He had put into place one of the most advanced operating theatres in existence, with a similarly well-appointed recovery room. He had toured the world and visited hospitals everywhere, yet at Chelmsford he appears to have decided that the safeguards, which at one time he had regarded as imperative, were no longer needed. There is almost no doubt that the work of Dr Sargant, which Bailey had encountered during his trip, had had a profound effect on Bailey. There is also no doubt that Bailey had continued to harbour the belief that coma therapy had at 42

CHELMSFORD PRIVATE HOSPITAL

43

its base a fundamental truth, and that prolonged coma could produce psychiatric benefits. Bailey was convinced that if left alone he could show those who doubted his competence that he could produce a psychiatric breakthrough. Flying in the face of medical opinion, which had relegated Deep Sleep Therapy to medical history, Bailey set out to implement a programme of deep sedation which combined with ECT and psychosurgery. What motivated him? One of the reasons put forward was that Bailey ‘really believed in the efficacy of the treatment’. If this was the case, why did he make no attempt to inform other psychiatrists of his discovery? It is contrary to all principles of scientific development for some­ one to have developed a treatment that would benefit thou­ sands of people yet take steps to ensure that it is kept secret. Up to this time Bailey had never lost an opportunity to promote himself — a low professional profile was entirely out of character. It has also been suggested by psychologist Dr Evan Davies that Bailey wanted to carry out a long-term research project on the effectiveness of Deep Sleep. Such a project would have been consistent with his apparent desire to prove that he was a professional without peer. Whatever his aims may have been, however, even at the outset, there would have been some detailed records kept and tests made, which would in some way have measured the success of the treatment. At no stage did Bailey even pretend to do this. Another theory, suggested by a former colleague, was that Bailey saw the unsupervised nature of a small private hospital, which allowed him to treat numbers of patients with Deep Sleep Therapy without review, as simply an opportu­ nity to generate enormous financial returns. But this is too glib. The early records of Chelmsford Hospital indicate that throughout 1963 the bed occupancy rate was well below the approved maximum of 15. It is also clear that had Bailey decided not to send his patients there it would not have operated profitably. However, the fact that there were times when the hospital was not functioning at full capacity even after Bailey’s arrival, and that Bailey did not send more patients to it to receive Deep Sleep, seems to weaken the theory that Deep Sleep at Chelmsford was merely a money­ making project.

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One of the major difficulties that arises in trying to ascer­ tain Bailey’s motive in prescribing the treatment is the fact that there does not appear to be any consistency with regard to who was selected to receive it. Patients whose records appear to be almost identical received different treatments, and only some were subjected to the Deep Sleep regime. However, it should be noted that within months of entering private practice he was one of the busiest psychiatrists in Sydney. He was certainly attracted to the good life and the trappings that went with it. He always drove expensive motor cars. He owned a rare pre-war German DKW car before changing it for a specially imported, custom-built Jaguar, which carried the personalised licence plates HRB 000. He dined out regularly, drank only the best wines, attended con­ certs and the theatre, and was well known among his friends for his overall generosity. He boasted to Dr Jules Black some five years after beginning his practice that he was earning $250,000 per year, sufficient at that time to purchase 10 suburban homes each year, and by the early 1970s he was able to indulge himself as a bon vivant. He habitually blocked out a large section of his Wednesday appointment book and substituted what he called his ‘Cham­ pagne club’. This was a regular wine tasting at which everyone who shared his Macquarie Street rooms was invited on the condition that they brought their best bottle of French cham­ pagne. The secretarial staff were all invited, and exotic cheeses were on the menu. A book was kept in which the group’s comments on the wine of the day were recorded. While these habits require a constant and not insubstantial income, Bailey seemed to treat the financial benefits which flowed from the practice of medicine simply as a means to finance the style of living he enjoyed. He made no attempt to amass any great fortune. Although his Chelmsford activities contributed to this income, even without it he was still generating more than most other medical practitioners. But what he really enjoyed, and indeed needed, was power. And much of this need could be satisfied now that he was in private practice and, as a psychiatrist, had some measure of control over other people’s lives. If money was not the lure, the explanation for his introduc­ tion of Deep Sleep Therapy may well still be simple — a

CHELMSFORD PRIVATE HOSPITAL

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mixture of ignorance and confidence, a dangerous combina­ tion which in the practice of medicine can be positively fatal. While Bailey had graduated in the early 1950s, he had not actually practised medicine since he left Sydney on his world tour in 1954. On his return he had set about constructing the CSRU, but as its director, not as a practitioner there. He had then become the medical superintendent at Callan Park, another administrative position. So, apart from his graduate work in psychiatry, his general medical knowledge had not increased since he had left medical school, and it can be surmised that his knowledge of pharmacology was limited. But while it is clear that Bailey was heavily influenced by Sargant’s treatment theories, he does not seem to have been influenced by Sargant’s warnings about the limitations of, nor the inherent dangers in, sedation therapy. It is known that even before Bailey had begun to introduce his own version of the treatment in Australia, Sargant had sounded the alarm. In The Physical Methods of Treatment in Psychiatry he wrote ‘.. . continuous narcosis has remained the most problematic of all methods of physical treatment in psychiatry, as its results are the least predictable.’ He acknowledged that there had been developments in drugs that had made the therapy redundant and that, at best, it was a symptomatic approach to psychiatry. He emphasised that this treatment made no attempt to deal with any of the underlying causes of the psychiatric problem. And he warned of the attendant dangers, stressing the need for the use of specially trained nursing staff. He concluded that ‘the decision to use this form of therapy must not be made light-heartedly’. A review of the medical literature available in the early 1960s shows that, apart from Dr Sargant, the psychiatric pro­ fession had completely rejected the idea that prolonged deep sedation offered the psychiatrist anything more than an inter­ esting view of medical history. Much of the early comment about Deep Sleep Therapy is restricted to its effectiveness as a psychiatric procedure. What is often forgotten is that, while the therapy may have been used to treat psychiatric problems, it required not knowledge of psychiatry for its successful use, but knowledge of anaesthetics, intensive-care medicine, internal medicine, neu­ rology and pharmacology — and much of this at a fairly sophisticated level. The reason is that artificial sleep can only

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be induced by the administration of drugs, and the quantity of drugs necessary to induce continuous sleep creates unwanted side effects. These side effects include the depression of the central nervous system which can have potentially fatal conse­ quences. Breathing is impaired, resulting in a reduction in the amount of oxygen supplied to the brain and, if the quantity is reduced too much, permanent brain damage can result. Pro­ longed body stillness, an obvious consequence of prolonged sedation, prevents the lungs from disposing of inevitable fluid build-up, and if not carefully monitored can result in pneumo­ nia. Similarly, prolonged body stillness and sedation drastically increases the likelihood of the blood clotting in the body’s extremities, and deep vein thrombosis in the legs. Deep sedation also reduces the ‘gag reflex’, the body’s auto­ matic response to foreign matter entering into the lungs. Because patients are kept in a prone position, stomach con­ tents can move into the oesophagus; if the gag reflex is sup­ pressed there is nothing to prevent foreign matter entering the lungs. This can result in death within hours. There are no drugs available which will deeply sedate patients and maintain that level of sedation without the indi­ vidual patient rapidly becoming acclimatised to the drug and therefore requiring increased quantities of it. This would not matter except that, while the body acclimatises to the sedative effect of these drugs, other adverse effects are cumulative. Consequently a time is reached when so much of a drug is required to cause ‘sleep’ that other side-effects will cause death. For this reason, even if the procedure could be carried out safely, the time that the treatment can be given is self­ regulating. It is therefore not possible to use a single drug in order to maintain a heavy level of sedation, so pharmacological cocktails become necessary. Unfortunately for the unwary, drugs used in combination often have the strange result of magnifying the effect of the individual drugs. This increases the risk of overdose. Professor Maurice Joseph, Professor of Anaesthetics at Sydney University, summed up the treatment by saying that it was the same as anaesthetising a patient and, as such, the same precautions needed to be taken. He stressed that all this infor­ mation was known and available in Sydney by 1958. Even assuming that Bailey’s Deep Sleep Therapy had some medical merit, it was essential that the procedure be carried out in a

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way that would reduce the likelihood of the above problems arising. Sargant had not been aware of all these problems when he began his work on sedation treatment during the 1930s, but by the time Bailey visited him the need for precautions was well known. Yet Bailey continued to believe that he could cure a wide range of psychiatric problems by prescribing a combi­ nation of two therapies; one, by this time, standard, and the other, even at the outset, almost totally discredited. The first, electroconvulsive therapy, had proved to be an extremely useful weapon in the psychiatrists’ armoury, even though its theoretical base was unknown. The second, Deep Sleep Ther­ apy, however, was something different. It was considered too dangerous, with unproven results. Either Bailey thought that the danger was overstated, or his limited knowledge stopped him from considering all the problems, but he was convinced that the poor results had been brought about by the timidity of those who were using it. ‘The depth of the coma is the critical thing,’ he was to tell his nursing staff. Bailey’s superficial knowledge of the properties of the drugs he was using meant that he did not take into account the multitude of medical factors which should have stopped him from attempting such a dangerous, unproven treatment. At the outset of the therapy programme at Chelmsford, Bailey was not absolutely sure of the best way of implementing his sedation techniques. Contrary to what is often depicted in motion pictures, it is extremely difficult to ‘put someone to sleep’ for a long period of time. This is because the body works hard to excrete foreign substances and, as a practical matter, it is only possible to put someone to sleep for about four hours. Any attempt to extend the period of artificial sleep requires such a large dose of sedative that serious complica­ tions or even death can result. Bailey apparently had at least this basic knowledge, and within a short time a routine was established that attempted to accommodate these problems. He decided that the drugs he needed must possess two main characteristics: they must put the patient into a coma-like state quickly and, at the same time, maintain this condition for some time. Most fast-acting sedatives are not long-lasting, so Bailey used a combination of two barbiturates. He chose amylbarbitone and quinalbarbitone: the former a short-acting sedative and the latter, long-acting. Conveniently for him, a

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capsule had been marketed which was a combination of these two barbiturates. It had been given the trade name Tuinal. Again, it was basic pharmacological knowledge that the body quickly adjusts to any constant dose of barbiturates, so Bailey gave instructions to the nursing staff that a dose of fast-acting, short-life barbiturate (phenothiazine Neulactil) should be given if the patient woke up before the ‘next dose’ was due to be given. Introducing this drug regime ensured that his patients were indeed put into a coma, but almost from the outset he encountered the medical problem of drug tolerance. The pre­ cise quantities of the drug cocktail created by using Tuinal combined with Neulactil, varied throughout the years, but on average the patients received 2400 mg of Tuinal during each 24-hour period. On top of this was added the Neulactil, the result being to approximately double the sedative effect of the Tuinal. The period between doses was usually four hours. Even though any individual patient’s response will vary according to such factors as previous drug use, body weight, and state of health, the quantities prescribed were far in excess of any doses recommended by the drug manufacturers. So excessive were these doses that one expert when questioned about them asked, ‘Is the patient still alive?’ 'Yet Bailey per­ sisted with the dosages. One expert who gave evidence at the Chelmsford Royal Commission said of Deep Sleep Therapy at its inception: ‘It surprises me that Deep Sleep Therapy, a treatment abandoned elsewhere in the world because of its ineffectiveness [should have been used].’ Clearly Bailey could not supervise the administration of all medication to all patients every hour of the day, so he pro­ vided his nursing staff with a broad outline to follow in order to maintain a certain level of unconsciousness for about ten days. He was not anxious to devote his spare time to the care of his patients, and regarded it as an unnecessary interference if he was called at home. He either failed to appreciate the seriousness of what he was doing or he simply didn’t care. Matron Ray from St Anne’s recalled at the Chelmsford Royal Commission that Bailey was not responsive to her requests for help: I felt he didn’t seem to care very much about his patients because when we would ring Mrs Bailey, she would say ‘he

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is still bricking up the bathroom’, and then he would be doing the toilet, and he had a great rebuilding programme, it seems, at Balmain [actually Leichhardt], where they bought a house and he was upstairs and downstairs and on ladders and somewhere else ... Bailey also arranged for Dr Herron to visit Chelmsford for the dual purpose of supervising patients and administering ECT since the treatment regime called for its almost daily admini­ stration. Herron was not employed by Bailey on a full-time basis, so it was necessary for him to organise his visits to Chelmsford at a time compatible with his regular work at the New South Wales Health Department. This could only be managed in the evenings. For his work Bailey paid Herron on a sessional basis. The system was to continue for 15 years. It is not uncommon for nursing staff to supervise the care of unconscious patients, especially in post-operative situations. When this is the case there are invariably built-in safeguards which take into account the limited knowledge and expertise of the nursing staff: medical practitioners must be available for emergency treatment; the ward where the patients are nursed must be appropriately equipped; and the nursing staff itself must be trained in the management of this particular type of patient. At the CSRU all these requirements had been ful­ filled, not only at Bailey’s insistence, but because it was the standard way in which patients were nursed. Yet when Bailey arranged with Chelmsford for his first patient to be admitted and to receive Deep Sleep Therapy, not one of these accepted procedures was in place. The attendance of a patient’s doctor during an emergency was made difficult by the fact that Bailey’s rooms were situated in Macquarie Street, the professional centre of Sydney, approx­ imately 45 minutes from the hospital — a long time during an emergency. Herron, although working closer to the hospital at North Ryde, was not free to attend at will. Some years later he was called to Chelmsford by the nursing staff to attend an emergency, but was unable to arrive inside a period of eight hours. As for equipping the sedation therapy ward properly, Chelmsford was light years behind the CSRU. Professor Joseph of the University of Sydney identified the requirements of a suitable ward for the Royal Commission: A nursing ratio

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of one specially trained nurse for every two patients in the ward. There is no place for nursing aides in an intensive care ward except to do some menial tasks. Special beds, electrocar­ diograms, endotracheal tubes, laryngoscopes, all emergency things to ventilate the patient, suction outlets on every bed, oxygen, preferably piped, respirators with alarms, emergency oxygen cylinders, portable X-ray machine, and extremely accu­ rate charting which would include the recording of both res­ piratory rate and fluid balance.’ Professor Joseph had been responsible for setting up the first intensive care unit in Sydney in 1957, and he was adamant that by 1963 the require­ ments which he identified were absolutely basic, and their need beyond dispute. Yet Bailey took no steps to ensure that the hospital was equipped in this manner, even though he had considered it appropriate at the CSRU. Nor did Bailey take any steps to ensure that the nurses employed by the hospital were in any way specially trained, either at the start of his association with Chelmsford or at any time thereafter — a period of 15 years. Bailey seemed quite satisfied with the situation, and in 1976 he was to tell the nursing staff at Chelmsford that ‘we found that the nurses were terribly good ... we have many . . . sisters here who come in, and at the end of a week they are on top of it ... it depends not much on previous training . . . either you get this or you don’t, I suppose.’ What was even worse than the disregard of essential safe­ guards was that Bailey delegated to the nurses at Chelmsford the role of drug prescriber. The broad outline that he gave to nursing staff for the administration of sedative drugs imposed on them the need to make a medical judgement about the depth of each patient’s sedation before any subsequent dose was given. Then they had to decide when and how much of the relevant drug was to be given to each patient. Yet the nursing staff received no instruction from Bailey or anybody else about the pharmacological properties of the drugs used, the risks involved in their use, the dangers of overdose, nor many of the contraindications for their application. Even at the outset this system was unusual because all the drugs were within the class that could not be given to any patient without a formal prescription from a doctor. Bailey’s was not only strange medical practice — it was also illegal. The general haphazard scheme was to continue for

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nearly eight years until the Health Department authorities intervened. Remarkably, when this happened, Bailey con­ vinced the head of the Health Department’s Poisons Branch, Mr Robert Dash, when he interviewed Bailey on 8 July 1971, that the discretion of the nurses was a vital part of the programme. It was agreed that the strict legal requirements would be satisfied if Bailey provided a set of written parame­ ters, signed by him, for each patient. As Bailey had already introduced a standard form treatment sheet, Dash approved its operation. Bailey satisfied himself that he was in control of his pro­ fessional activities by setting up a system whereby he could communicate with the staff at Chelmsford. He arranged for a special book to be kept in which he wrote his instructions to the nursing staff about each patient. This became known as ‘Dr Bailey’s Book’. The practical reason for the book is obvi­ ous: Bailey’s visits were infrequent and at odd hours, so the book was a convenient method of communication to all nurs­ ing shifts. But there was another reason. Bailey spoke of Chelmsford as though it was his hospital, even though this was not the case. He used this term so often that every investiga­ tion into Bailey and his treatment has started with the premise that he had at least some proprietary interest. The existence of the book in which only his patients were recorded, also added to this misconception. Yet, having established what could have been a useful method of communication, he made only limited use of it. The cryptic nature of his instructions tells much about the relative roles of those involved in the provision of the treat­ ment and leaves no doubt that it was to the nursing staff that all relevant decisions had been delegated, and upon whose shoulders fell the duty of carrying out most of the treatment. Bailey used a number of standard words in his instructions. ‘Deep Sedation’, ‘Maintain’ and ‘Lighten’ are repeated over and over again, although, when subsequently questioned about these instructions not one of the nursing staff was able to be precise about their meaning. They seemed to mean: ‘begin the standard drug regime’, ‘keep on with the standard drug regime’, and ‘stop the standard drug regime’. There were never any instructions that indicated an individual’s age, weight, previous history, or nature of illness, all factors which

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are medically relevant when drugs are being prescribed, and therefore grounds for a variation of treatment. Bailey believed in the notion that if some is good, more must be better. Thus he decided that if sedation was good, then the deeper the coma the better, and that if ECT was good, then the more the patient received the better. Further­ more, if ECT was helpful in a wide range of psychiatric prob­ lems, and Deep Sleep was also helpful in a wide range of psychiatric problems, then in combination they must be useful in treating practically the whole gamut of mental disturbances. He also, therefore, considered that if some drugs produced a good result, then more must produce a better result, so he prescribed with gay abandon. He even went so far as to boast to one patient that he was the largest provider of a drug called Parstelin in the Southern Hemisphere. Even allowing for Bailey’s normal exaggeration, the records reveal that he pre­ scribed at a greater rate than other psychiatrists. Dr Herron has opined that Bailey saw Deep Sleep as a procedure which could approximate the effect of brain sur­ gery, that because of the impossibility of carrying out surgery at the same rate as Deep Sleep, this latter procedure was seen as a substitute. Yet in his papers on psychosurgery, which appeared on three occasions between 1969 and 1973 in the Medical Journal of Australia, only a passing reference is made to Deep Sleep Therapy. Even though Bailey no longer had access to the resources of the CSRU, he still harboured the belief that psychosurgery provided the real answer to most psychiatric problems. At the same time as he introduced his programme of Deep Sleep he set about ‘testing’ the efficacy of psychosurgery. Dr John Dowling had moved to the main neurosurgical unit in Sydney, Prince Henry Hospital. Dowling appears to have been just as anxious as Bailey to prove the benefits that could flow from this radical treatment, and Bailey was to later claim that he and Dowling had been responsible for the ‘largest number of psychosurgical operations in the Southern Hemi­ sphere’. Bailey’s criteria for the selection of patients for psychosurgery seems to have changed from the time when he was the director of the CSRU to the time he began private practice. During the whole period that Bailey was director no more than 20 operations took place, yet by 1967, within four years of entering private practice, he was to claim that over

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300 of his patients had received this treatment. And this, even though the CSRU had been established, at enormous cost, largely with psychosurgery in mind. In private practice, however, it is rare for any medical specialist to be forced to justify any form of treatment chosen for any particular patient. Just as Bailey was free to prescribe Deep Sleep Therapy to his patients — provided the owner/ matron of Chelmsford, Matron Howard, was prepared to give him access to her facilities — so was Dr Dowling free to treat his private patients surgically as he saw fit, and consequently he was able to carry out brain surgery without review. Bailey considered himself to be in direct competition with anybody involved in psychiatric research. He deeply resented the fact that the new director of the CSRU, Dr John Sydney Smith, was receiving international recognition for his research into psychosurgery, and he was determined that such people should not be granted equal standing with himself. Using his pool of privately referred patients as a base, he set about proving his point. Bailey had little or no perception of the rigour necessary to produce worthwhile research conclu­ sions, nor was he sufficiently self-disciplined to undertake any long-term project. Patients’ case histories, the basis upon which any research findings could be made, were often scrib­ bled on the back of manila folders, and contained nothing more than odd snippets of gossip and cryptic medical com­ ments. Furthermore, he was not psychologically able to approach a research project with an attitude of mind that included the possibility that he might be wrong. In an article on psychosurgery published in conjunction with Dr Dowling and Dr Davies in the Medical Journal of Australia in 1971, Bailey wrote: All patients in this series had been exposed to intensive psychiatric treatment for periods of five or more years before operation. In all cases the operation was selected as the procedure most likely to alter what otherwise would be a hopeless and fluctuating prognostic vista. His definition of ‘hopelessnes’ was ‘failed to respond to Deep Sleep therapy’. While Herron has denied that Deep Sleep was an exper­ imental procedure, Evan Davies has acknowledged that

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Bailey’s desire that there should be a team was based on the need for research to continue even though they had been cut off from the resources of the public sector. Bailey took active steps to ensure that he continued to lead such a team. He still hoped that he would be able to show those who were now more open in their private professional criticism of him that his ideas about psychiatry were soundly based. His loyal team included Mrs Audrey Church, who had been his secretary at Callan Park and had continued in his employment; Dowling, who was anxious to perform Bailey’s recommended surgery; Dr John Herron, who, although not willing to leave the public service, was prepared to contribute to the team as a junior medical officer; and Evan Davies who was prepared to supplement his meagre academic salary by carrying out psychological tests on Bailey’s patients. Until this stage it could still be possible to explain the implementation of treatment on the grounds that Bailey thought he was right, and desperately wanted to prove it, but a number of circumstances suggest this may not have been so. The combination of ECT and Deep Sleep meant that the patients were billed for both procedures. It was standard prac­ tice then, and has been since, for ECT to be given to a patient only when the patient has been put under an anaesthetic. Bailey obviously decided that any patient who was deeply sedated did not need an anaesthetic, and, in a majority of cases, the nursing notes reveal that no anaesthetic was given. Bailey, however, as it is known from patient records, almost universally charged the patient, or the insurance company, or, with the introduction of Medibank, the government, for both the ECT and the anaesthetic. While Bailey was quite happy to swindle others, he reacted indignantly if he was being ‘ripped off. An example of this was when he booked seats at a popular musical for himself and his daughters, but when they arrived there had been a mix-up and the seats were not all together. He created such a fuss that the management gave him complimentary tickets to see the show again. The comparison between Bailey’s career in the public sector and in private practice reveals an interesting paradox. As director of the CSRU he was duty-bound to ensure that the research unit was staffed by experts — those professionals who had established themselves within their particular medical

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specialty. While he may have been the front-man and respon­ sible for the public-relations side of the operation, there was no way that any surgeon, anaesthetist, neurologist, or other specialist would have been prepared to follow ‘professional’, as distinct from ‘administrative’ instructions from Bailey. Thus any glory for Bailey would only have come from the technical achievements of others, although he could claim to have been the founder and promoter of the whole enterprise. His promotion to the position of medical superintendent at Callan Park removed him further from the role of medical researcher, and placed him squarely into the role of a medical administrator. While this position had the effect of potentially placing him in the public eye, it effectively removed him from the practice of medicine. There is no doubt that he revelled in the apparent power that this position gave him, but, in reality, his real power was extremely limited. Not so at Chelmsford.

CHAPTER SIX

THE POWER OF LIFE AND DEATH

By the end of 1963 Bailey was firmly established in private practice. He knew that he was regarded with suspicion by his psychiatric colleagues, but he satisfied himself that this was due to their inability to understand what he was doing. He realised that he could not totally distance himself from his fellow professionals, so he concentrated on cultivating general practitioners, gynaecologists, and lawyers. In the company of this group he was considered to be intelligent, totally free from pretension, and certainly up to date with current world­ wide psychiatric thought. It is not difficult to impress the uninformed, especially for someone like Bailey who, although he might have been seen as a rebel, had had nothing but public praise heaped upon him from all quarters. For any fellow psychiatrist to question the public’s judgement of him was to sound like sour grapes, and was to be rejected With this new circle of acquaintances lionising him, Bailey now spent most of his time in his rooms seeing patients who had been referred to him by other medical practitioners, or those coming in increasing numbers from lawyers who were anxious to obtain a report on the psychiatric condition of their clients. Bailey’s willingness to give opinions in medico-legal matters, and his willingness to attend court hearings to support his opinions, made him extremely popular with lawyers. He was articulate and clear and able to explain psychiatry in terms that lay people, whether judges or jury, could understand. He was always prepared to explain a psychiatric condition by making an analogy to a circumstance that could be compre­ hended by any listener. He used this means of description when he explained the nature of Deep Sleep Therapy to his patients. It was typical for him to tell his patients that their 56

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brain ‘needed a rest ... that just as a good sleep enables the body to wake up refreshed, so a good sleep will enable the brain to wake up refreshed.’ To the brother of a patient, he described brain surgery in the following terms: ‘If you consider the mind like a series of roads and highways, the operation will block off some roads and send the thought messages out at different directions.’ Bailey also explained that he ‘would try and change her exist­ ing method of thinking’. With Dr Herron relieving Bailey of the need to visit his patients on a daily basis, and the delegation of the role of medical decision-maker to the nursing staff, he supervised his Deep Sleep patients by calling in at the hospital about two or three evenings per week. Although Mrs Bailey has suggested that he chose to specialise in psychiatry because he wanted a nine-to-five job, at no time did he work these hours. As his practice boomed and he increasingly indulged his interest in theatre, concerts and opera, he visited Chelmsford later and later, often not arriving until the early hours of the morning. He was in constant demand as an after-dinner speaker, and his friends all testify to the fact that he was a marvellous dinner guest. He took an interest in many things, but, while he became sufficiently informed in a wide range of subjects at a level which impressed those who were not so informed, he never seemed to go much below the surface. Just as Bailey’s treatments were unconventional, so was his attitude towards his patients. Almost from the moment he entered private practice he was unable to maintain a proper professional distance between himself and his patients. One of the first instances of this involved Jill Myers, whom he had first treated at St Anne’s in 1963. Jill was an emotionally disturbed 18-year-old who had been treated unsuccessfully by the well-known psychiatrist Dr Cedric Swanton. Jill’s father, a suburban pharmacist, had attended a lecture given by Bailey during which Bailey had given the impression that he was both a trained pharmacist as well as a psychiatrist. Bailey’s obvious communication skills and his apparently extensive knowledge of all aspects of medicine impressed Mr Myers and lead the Myers family to consult Bailey about Jill’s problems. Although the precise nature of the treatment is not known, for the records no longer exist, Bailey soon began to visit the

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Myers’ home, which was situated above the pharmacy. His visits seemed to coincide with Jill’s parent’s absence. He also seemed to regard it as his right to help himself to any stock from the pharmacy shelves and, when challenged by a member of the family about this rather odd activity, he simply announced that he wanted the cosmetics, toothpaste and per­ fume to give to his mother as a present. When Mrs Myers challenged Bailey about this, and, as well, about what seemed to her to be overly large consultation fees, he lost his temper and claimed that Jill would never get any better because she had inherited her obsessional behaviour from her father. Mrs Myers recalled at the Chelmsford Royal Commission that ‘he was very wild, very indignant and very angry ... I had seen him arrogant and going on and showing off, but I had not seen him really angry.’ Mrs Myers believes that it was Bailey’s refusal to respond to a cry of help from Jill after she had had a row with Bailey that finally caused her to take her life. It is common knowledge that psychiatric patients often look to their doctor for the solution to all their problems and that they frequently see the therapist as a manifestation of all that is perfect. This puts the psychiatrist in a position of great power and, as a matter of normal professional practice, is treated with great caution. Bailey would have been aware of this, yet his intrusion into the private life of the Myers family was but one example of his inability to separate private from professional relationships, a habit which was to plague Bailey for the rest of his life. Corresponding with his failure to appreciate the power that psychiatrists have over their patients was his failure to realise that a certain standard of professional conduct is often expected by patients. Bailey saw himself as carrying the mantle of egalitarianism provided, of course, that he was dispensing the supposed barrier breakdown. He would often greet patients in his surgery without rising, with his shoes off and his feet stretched out across his desk. He had a prurient sense of humour which he sometimes used to try to shock his patients or, as Mrs Myers suggests, simply to show off. To one patient who consulted him in 1963 because she could not sleep, he replied, ‘. . . [your] husband should be very pleased if [you] are awake all night ... he would appreciate that.’ Dr Jules Black saw Bailey’s informality as simply ‘telling it

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the way it was’. Bailey felt that ‘the medical profession tended to talk down to people’, but, Black continued, ‘Harry used words that people understood. He spoke in their down-toearth language. If he had to ask if someone had defecated recently he would say to them “have you had a shit?” ’ Accordingly, Bailey was to tell Mr Robert Whitty, the hus­ band of one patient to whom he had recommended psychosurgery, that this operation was necessary because his wife was now ‘on the bottom of the heap’. While this overfamiliarity with patients may have been unusual, and his capacity to overstep the boundaries between his professional relationship with his patients and intrusion into their private lives a misuse of his influence as a doctor, it was Bailey’s disturbing attachment to his treatment in the face of its almost worldwide dismissal that led to tragedy. One power that doctors had, and to a degree still have over their patients, stems from the mystique entailed in their superior knowledge of how the body works and how to treat it when it goes wrong. As psychiatrists treat the brain and its function, this mystique, and consequently the doctor’s auth­ ority, is even greater. A patient’s willingness to believe in and trust their doctor’s treatment bestows great power on the doctor. Therefore, if, as Bailey suggested, the premise upon which his Deep Sleep Therapy was based was sound, then obviously the patient must conclude that the therapy would work. It would have taken another psychiatrist, not a patient, to con­ clude that the therapy would not work. It would have taken another psychiatrist, not a patient, to know that the premise was wrong. And only other medical practitioners would have known that this artificially induced sleep does not put the brain to rest: that the consequences of drug-induced coma include considerable physical stress, and that the drugs which had to be used to induce this artificial sleep caused wild hallucinations which created the absolute antithesis of brain rest. In ignorance patients can assume that poor results or complications arising from their treatment are not caused by the treatment itself. They frequently blame themselves. While it is not possible to quantify Bailey’s state of medical knowledge at the time that he began Deep Sleep Therapy in 1963, within six months of its introduction the situation was entirely different. It is possible from patient records to identify

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the consequences of any treatment which are not psychiatric in origin. Within six months of starting his Deep Sleep programme dangerous complications began appearing with disturbing frequency: pneumonia, constipation, drug rash, urinary retention, chronic respiratory problems, urinary tract infections, excessive mucous, vomiting, temperature fluctua­ tions, bed falls and fractures, foot drop and dehydration. But none of these deterred Bailey. Again, even if it is accepted that these physical complica­ tions ultimately rectified themselves, and the patients suffered no lasting disability, the events of July 1964 must have at least caused Bailey some concern. Within four days two patients, who were in good physical health prior to their admission to Chelmsford, died. Deep Sleep’s first victim, Muriel Kell, 53, is recorded as ‘suddenly became pale and cyanosed’. Her nursing notes from Chelmsford are missing but Bailey’s notes show that she had been diagnosed by him as suffering from menopausal depres­ sion and had been transferred from Crown Street Women’s Hospital to Chelmsford at his instigation. A side effect of deep sedation is cyanosis (blueness caused by poorly oxygenated blood). The second, Antonios Xigis, 28, died three days after being admitted for post-traumatic depression. All his medical records have disappeared. By this time it was impossible that Bailey remained unaware of the dangers inherent in his treatment. Yet there is no indication that they dissuaded him in any way, nor that they caused him to modify his regime. Mrs Bailey has said that her husband ‘never expected any of his patients to die’. Jan Allan, who acknowledged at the Chelmsford Royal Commission that from 1968 to 1978 she carried out the dual role of office manager and lover, said, when asked about Bailey’s reaction to patient deaths, ‘He was definitely distressed about it. He was very concerned that it happened. He tried to take steps [to ensure] that this sort of thing would not happen again . . . When I started working for him he told me of a couple of instances of patients dying in previous years. In one case a man had died of pneumonia, and I think there had been an inquest into that. Following that he had ensured that all patients having Deep Sleep treatment would have nose and

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throat swabs taken routinely on admission. I am pretty sure he had a physiotherapist see the patient . . .’ Jan Allan was mistaken about the physiotherapist, and chest problems continued. Between July 1964 (just over a year since Bailey had moved to Chelmsford) and 23 December 1964, five patients died while undergoing Bailey’s Deep Sleep Therapy. By this time approximately 150 patients had received the treatment. It has been common for some of Bailey’s supporters to suggest that patients die in all hospitals, and that this was just an unfortunate coincidence. As well, Bailey’s reaction to these deaths was quite peculiar, and refutes this suggestion. He altered death certificates; claimed to be in attendance at the hospital immediately prior to the deaths of patients, but usually wasn’t; and he registered causes of death which medi­ cal experts have since claimed he could not have known about without conducting more extensive tests. This allowed him, however, to avoid the detailed investigations of his methods that would have arisen during the course of any coronial enquiry. What is more, his supporters ignore the fact that while psychiatric patients may at times take their own lives, there is nothing about any conventional psychiatric treatment which either then, or now, could be regarded as life threaten­ ing. Every medical student receives instruction about the legal requirements imposed upon doctors about reporting patients’ deaths. Bailey was well aware of his obligations, and had even made the Callan Park’s staffs failure to act appropriately when a patient died the subject of one of his own formal complaints to the Health Department. These legal requirements, which clearly cover the situation that applied at Chelmsford were, and still are, set out in legislation called the Coroner’s Act. This legislation has been changed over the years, but it had then, and still has, the effect of requiring a formal report to be made by the medical prac­ titioner concerned if a person ‘has died while under, or as a result of the administration of an anaesthetic during the course of a medical, surgical or dental procedure, or an oper­ ation or procedure of like nature’. (Section 1 l[f] Coroner’s Act 1960) All patients who received Deep Sleep Therapy were uncon­ scious and, in Bailey’s own words, ‘it was the depth of the

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coma that was relevant’. Yet Bailey took extraordinary steps to ensure that Chelmsford patients were not made the subject of coronial inquiries. He was not always successful and, after the death of Antonios Xigis on 20 July 1964, Bailey gave evidence at the inquest. Here he admitted for the first and last time that there was a possibility that the death of one of his patients may in part have been due to the quantity of barbiturates given during Deep Sleep Therapy. Had inquests been held for the four other patients who died in 1964 the whole course of events at Chelmsford would have been totally different: as well as Muriel Kell, who died on 16 July and Xigis on 20 July, on 6 October, Kelvin Kingston, 45, admitted suffering from chronic intermittent alcoholism and epilepsy, died; on 12 October, Frederick Echardt, 56, admitted suffering from depression, died; on 23 December 1964, Mary Rodgers, 47, who was also admitted suffering from depression, died. The circumstances of Mary Rodger’s death were identical to those of the previous four. On this occasion, however, as the acting matron of the hospital, Mrs Beverley Edwards, after failing to resuscitate the patient, began writing an account of the circumstances surrounding the patient’s death into the hospital records. Bailey stopped her. She told the Chelmsford Royal Commission: I remember after Dr Bailey arrived that I sat down in the office to write the appropriate entry on this patient, and I particularly remember the fact that Dr Bailey came into the office, looked over my shoulder and said, “What do you think you are doing?” When I explained to him, “I am just writing the report on this patient”, he grabbed it and ripped it out of the book, tore it up, and told me to mind my own business. The matron also recalled that she ‘was writing a very accurate description of what took place.’ This included a description of ‘. . . the deep sedation that went on beforehand’ and ‘the depth of the sedation’. The matron continued, ‘I believe I wrote exactly that’ [the depth of the sedation] and ‘I think that made him angry.’ Bailey’s response can only be described as startling. Not only did he rip the page from the book, but he substituted the following information: ‘Satisfied that (1) airway was clear, (2)

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patient not over sedated, (3) in view of history of cardiac dysrhythmia (extra systoles), issuing certificate for coronary occlusion.’ This report ignored the fact that the resuscitation of the patient included an attempt to clear the airway and that the nursing staff were given no information about any previous heart condition. Not to mention the fact that sedation of the nature involved in the Deep Sleep programme should never have been given to anybody whose physical condition was in any way suspect. An analysis of other death certificates issued also show that Bailey was less than honest both about the treatment and the cause of death. He was even prepared to claim that he had attended the hospital and examined a patient (whose name cannot legally be revealed) immediately prior to the patient’s death when the nursing notes reveal that he had not been to the hospital for two days. Whatever justification could be made for the introduction of the programme prior to this point, it was now clearly a failure, and Bailey could only be aware of the reasons for this. Even following the detailed investigations of the Royal Com­ mission no evidence has ever emerged of any success which can be specifically attributed to Bailey’s Deep Sleep Therapy. But he was not prepared to face up to the reality of the situation. There were only limited options open to him: he could either abandon the programme or modify it; or, if he was confused about why things had gone wrong, he could call in other experts. He took none of these options. In retrospect it is obvious that this latter choice would always have been unacceptable to him. To admit to anybody, especially another doctor, that he was confused about any medical matter would have been very embarrassing. During the next two years (between 1965 and 1967), about 250 patients were prescribed Deep Sleep Therapy, and during this period there were five more deaths at the hospital. In each of these cases Bailey registered the cause of death, but in only one instance, after the death of a Mr Graeme Carter in 1967, was there a formal coronial inquiry. It has subsequently been discovered that in each of these cases Bailey’s explanation of the cause of death was designed solely to ensure that he was not subjected to an official investigation. Graeme Carter, 23 died on 3 May 1967, seven days after he had been admitted to Chelmsford suffering from depression.

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Carter’s wife later told the Chelmsford Royal Commission that she had been so shocked by her husband’s appearance that she rang Dr Bailey and asked him to stop the treatment. Bailey told her that her husband would be ready to leave within 48 hours, but the records show that Carter’s quantity of barbiturates was doubled the day before he died. Before Graeme Carter’s inquest in 1967, Bailey made a statement to the investigating officers. In this statement he gave a general description of Deep Sleep Therapy and its method of implementation. It was essentially accurate, except in two key areas. He claimed that the treatment was monitored by specially trained staff, and that the facilities at Chelmsford were equivalent to those available in an intensive care ward at a private hospital. He was still repeating these assertions to another inquest almost 10 years later. Bailey had no reason to lie if he did not know that these facilities were vital for the safety of the patients. An examination of the proceedings of Graeme Carter’s inquest shows that the Coroner, Mr Len Nash, accepted the word of the treating doctor, in this case Bailey. Mr Nash was presented with a series of reports which identified the treat­ ment as ‘probably’ contributing to the death. Professor R. H. Thorpe and Mr L. B. Cobbin, both from the pharmacology department of the University of Sydney concluded that ‘the interaction of the separate drugs in dangerous individual dos­ ages on an underweight patient could have lead to his death’. In his report the Coroner made no reference to these reports and concluded that the patient had died as a result of the rapid onset of a virulent pneumonia — which had taken just two hours to cause Carter’s death. In his final opinion, the Coroner did refer to the problems associated with the delega­ tion of medical decision making to the nursing staff, but he was not prepared to go so far as to hold that it was a contrib­ uting cause of Carter’s death. There can be no doubt that had all the deaths been made the subject of a hearing it would have been impossible for Bailey to explain away the repetitive nature of the symptoms. Following the Carter inquest Bailey vowed to Jan Allan that he would never go through such an ordeal again and took drastic steps to ensure that this did not occur: he falsified causes of death, destroyed patient records and obstructed any attempt to investigate patient care at Chelmsford.

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The first five years of private practice had certainly been eventful. Few psychiatrists could boast that their treatment had directly resulted in 10 deaths and even fewer could claim to have successfully ‘pulled the wool over the eyes’ of the health authorities. Bailey had done it all. The only insight that we have into Bailey’s real feelings during this period is provided by the fact that he took some steps to move his field of operation from Chelmsford. He told his friends, and even in 1971 an official from the Health Department, Mr Robert Dash, that he was dissatisfied with the quality of the nursing staff that was being provided at the hospital, and that he was going to establish his own. This new hospital would result in the perfect Deep Sleep Clinic. To this end, Bailey went beyond the stage of mere words, having purchased in 1969 an old house in Rogers Avenue, Haberfield. His grand plan included the total renovation of the premises and its conversion into a private hospital. He had even chosen a name for his dream clinic well in advance of the time that it would ever be ready to receive its first patient. It was to be called Mandala. In both the Hindu and Buddhist religions the mandala is a representation of the universe, and is a consecrated area that serves as a receptacle for the gods and as a collection point of universal forces. Carl Jung, the Swiss psychiatrist, produced mandala-like paintings of his patients and believed that the spontaneous reproduction of these paintings by his patients was an example of their attempt to integrate the unconscious with conscious material. For Bailey to consider this name appropriate to his hospital was either a joke, or shows an incredibly inflated view of his own importance. If it was a joke he must have been extremely disappointed, because relatively few people would have under­ stood its meaning. It was typical of Bailey that he decided that only he was capable of carrying out the alterations to the building. It was also typical of him that he should take it upon himself to carry out this work when the alterations to his own house in Piper Street, Leichhardt, had still not been completed. It provided him with a perfect excuse to be absent from the family home whenever he saw fit. There can be no other reason for him not realising this supposed dream at any time he chose. Private hospitals were proving to be a sound investment, and with the income he was generating from his practice he could easily

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have financed the renovations rather than do them himself. He also rejected a number of overtures from others who suggested they enter into some financial arrangement with him. He told Herron that he was frightened that he would lose control. His dream hospital was never to be completed and never admitted a single patient, although Bailey included his position as ‘Medical Director of Mandala Private Hospital’ in his entry in Who’s Who. Twenty years later Mandala remains the centre, not of the universe, but of a dispute over the remains of Bailey’s estate.

CHAPTER 7

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Bailey’s inability to separate his private from his professional life was to create enormous hardship for his patients, distress to his family, and ultimately cause his colleagues to attempt to prevent him from practising medicine. By 1969 he was constantly absent from the matrimonial home. The new property, Mandala, imposed a financial burden that could only be met by undertaking what Mrs Bailey described as ‘a double shift’. The excuse of the ‘double shift’ left him free to indulge in ‘extracurricular’ activities. Bailey seemed to be totally unable to refrain from making sexual advances to patients, while at the same time he had established a relationship with his secretary/nurse Jan Allan. It is difficult to know how much Mrs Bailey knew the extent of her hus­ band’s activities but Jan Allen recounted to the Royal Com­ mission the story of Mrs Bailey telephoning the surgery and enquiring whether or not the last patient of the day was a female. If she received a positive reply Mrs Bailey would ask Jan Allan to remain behind in the office. Mrs Bailey was apparently unaware of the fact that by this stage Bailey was sexually involved with Allan. This relationship was to last for 10 years. One of the most basic ethical aspects of the practice of psychiatry is the absolute prohibition of any sexual involve­ ment between patient and doctor. While this prohibition relates to other fields of medicine as well, the very nature of the relationship between a psychiatrist and patient accentuates the need for extreme caution. It is not unusual for an emotion­ ally distressed patient who receives help from a therapist to believe that the therapist is the manifestation of all that is good, and to further believe that between them is a mutual feeling of love. It is part of a psychiatrist’s skill to ensure that these feelings are given no encouragement, even though the situation puts the psychiatrist in a tremendous position of 67

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power. The abuse of this power has been the subject of numerous books and court cases, and is analogous to the apparent hold that Rasputin had over the last Tsarina of Russia. Bailey ignored this basic ethic and turned many of his patients into personal playthings. Evidence of this unethical behaviour has been presented at a number of hearings involv­ ing Bailey. Many of his former patients have revealed, however, that Bailey had no inhibitions in suggesting to them that some of their emotional problems had their origin in sexual inhibi­ tion, and that he was the person who could cure it. As reported by a patient at the Chelmsford Royal Commission, who cannot be named, it was not unusual for him to suggest ‘What you need is a good fuck, and I am just the person to do it!’ Unfortunately for his patients, he would discard them soon after and this often left them more emotionally scarred than when they first consulted him. On a number of occasions former patients attempted suicide after being rejected by Bailey. It is most unusual for a patient who has been duped in this way to complain, because the revelation of the relation­ ship itself is a public demonstration of the complainant’s own weakness, and brings with it acute embarrassment. As with many of Bailey’s activities there was, at their core, a modicum of psychiatric sense. By 1968 he was the visiting psychiatrist attached to Sydney’s Crown Street Women’s Hos­ pital. He was aware of the growing emotional problems that the sexual revolution of the 1960s had created, and he was convinced that it was the enforced sexual inhibitions that existed in society that caused much of the tension between married people, and much of the stress associated with child­ birth. He read all the avant garde literature on the subject and became an editor of, and contributor to, the controversial sex-oriented magazine, Forum. He was sure that if he could just get his patients to talk about their sexual problems then this would go a long way toward their solution. The extreme conservatism that existed in hospitals such as Crown Street meant that he could not be too open about his activities, yet he was determined to estab­ lish a formal sex clinic. He was given permission to set up a department of Gynaecological Psychiatry, which was in reality a sex counselling clinic. There he attempted to break down

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some of the barriers by using language which he thought would both shock and relieve tension. He would often begin a consultation with ‘how are things in the fucking department? ’ But, as with practically everything he did, he had no idea when to stop. According to one of his lovers, Bailey talked incessantly about the need for women to achieve ‘the big “O” and I am not talking about Roy Orbison!’ As a practitioner of the art she rated him eight out of ten. The best known example of Bailey’s sexual misbehaviour concerned his affair with Sharon Hamilton. Sharon Hamilton was a small-time cabaret dancer. On 18 June 1972, with a party of 16 other dancers, she went to a Sydney gaol to perform for the inmates. While there, she unwittingly found herself involved in a gaolhouse scheme designed to ensure that two inmates obtained early release from the institution. The scheme was simple. One of Australia’s most notorious villains, Lenny Lawson, was to pretend to attack one of the perform­ ers, while the two who wanted to be released were to carry out a rescue that would stamp them as heroes. With his reputation Lawson was the ideal villain. He was a convicted multiple murderer and rapist, who was currently serving time for holding 100 schoolgirls hostage in their school chapel. Sharon was chosen as the ‘victim’, but the scheme went wrong, and Lawson, apparently accidentally, cut her about the arm and neck with a knife. The incident gained national publicity although the background of the scheme remained a secret. Some time later Sharon decided to sue the New South Wales Government for compensation for her physical and emotional injuries, so she consulted a lawyer. It is standard practice in cases of this nature for the lawyer to obtain a psychiatric assessment of the patient, especially as it can assist the plaintiff in a claim for damages for emotional suffering. Bailey was well known as a plaintiffs psychiatrist and it was not surprising that Sharon should be referred to him. Jan Allan recalls that Sharon was different from most of the patients who were sent to Bailey, and Sharon herself told her friends that she regarded her visit to a psychiatrist ‘as a bit of a joke’. She laughed at the thought of completing a psychiatric assessment, and, although she agreed that the gaol experience had left her a bit shaken, she claimed that she was the last person who needed psychiatric help. She was confident that

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her visit to Bailey was only designed to help her win her claim against the government. Surprisingly, her visits to Bailey soon went beyond psychiatric assessment, and her friends noticed that she had begun to take large doses of pills; ‘Sharon was not the type of person to take pills, if anything she was a bit of a health crank’. Within a short time her friends noticed that Sharon had become distant and appeared to be depressed. She told a former dancing partner, Valmae Lane, that Bailey had suggested she needed a good rest, and that he had this special place that was designed to enable people ‘to pick themselves up’. Sharon entered Chelmsford Private Hospital on 2 August 1974. Her friend Mrs Lane heard that she had gone to hospital and went to visit her there. When I arrived I said to her that this was no place for her. I intended to pack her belongings and take her from the hospital. Sharon told me that she intended to stay and that I was to leave her belongings alone. I was surprised because I thought I knew Sharon well and I did not think that she was in need of psychiatric treatment. It was clear that by this time Bailey’s influence over Sharon was complete. She acquiesced to Bailey’s suggestion that she receive Deep Sleep Therapy. The consequences of this treat­ ment were drastic: she lost almost 20 kilograms in weight and became extremely lethargic. Her friends recall that ‘Sharon didn’t laugh any more’ and along with her family, they begged her to change doctors, but she refused. A former nurse at Chelmsford has since opined that ‘there wasn’t a bloody thing wrong with her!’ Bailey, however, had told Sharon that her family was bad for her. By the time she left Chelmsford the first time she was totally dependent on Bailey-prescribed drugs and had become self-obsessed. According to her friends she seemed to believe that the most important aspect of her life was the next dose of pills. While Bailey continued to treat her she was to spend all but 76 days of the next two years in Chelmsford. And during that time it became obvious that Bailey and Hamilton were having a sexual relationship. It became so open that whenever she was at Chelmsford she was provided with a private room

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which she and Bailey used for their lovemaking. And during this period she twice attempted to commit suicide by taking an overdose of the barbiturates Bailey had prescribed. Many of her friends, however, are of the opinion that these were only attempts to gain Bailey’s attention. The case brought by Sharon against the New South Wales Government, in the person of the Director of Corrective Services, was heard in April 1976, and she was awarded $99,381.66 damages. This sum represented about 15 times the average yearly income. Bailey gave evidence about the psychological damage she had suffered as a result of the attack. Without his evidence the award would have been much less because the actual physical damage she suffered had been slight. The numerous instances of hospitalisation subsequent to the attack also contributed to the parcel of evidence that demonstrated the amount of damage Sharon had suffered. In retrospect, Bailey’s relationship with Hamilton defies explanation. She seemed to provide him with nothing that he could not have obtained elsewhere without the problems that she brought with her. She was rather clinging and, as time went by, more demanding and obsessive. There is, however, one possible explanation which shows Bailey as a Machiavellian schemer. Bailey at one time told a former matron that he ‘was screwed by the government and he was going to screw them’. If this explanation is true, it demonstrates that Bailey either had no regard whatsoever for the well-being of Sharon Hamilton, or else he did not realise that the continued unnecessary treatment that she received brought with it its own medical ramifications. This second alternative must be rejected, because even Bailey must have known that barbiturate drugs are addictive, and that by per­ sisting with them Sharon’s health would be adversely affected. While the successful outcome of the Hamilton case may have satisfied Bailey’s ego, he was now so involved in her life that he could not simply walk away from it. She demanded his constant attention and was not concerned if she caused him any serious embarrassment. Without any objection from the hospital’s administrators she treated Chelmsford like a motel, and she continually embarrassed the staff and Miss Allan by giving them expensive presents. At Chelmsford she could be certain of seeing Bailey — at least on those occasions that he visited the hospital. Any attempt Bailey may have made to

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terminate the relationship was negated when he sent a taxi to Chelmsford to pick up Sharon late at night to take her to his rooms at Macquarie Street. He told the nursing staff, whom he assumed to be both unquestioning and gullible, that Sharon needed a late-night consultation. On one occasion a nurse entered her room to see her sitting on the bed clipping her pubic hair with nail scissors. Sharon was not the slightest bit embarrassed and simply told the nurse that ‘Harry likes it this way’. Apart from Bailey’s continued fraud with regard to charging for anaesthetic that he did not give, there had, until this stage, been no indication that he was interested in anything other than personal gratification. Sharon’s financial settlement, how­ ever, shows Bailey in a different light. Bailey was still talking about his future plans for Mandala but had made little real effort to complete them. He would spend weekends there, and would suggest to patients that it was good therapy for them to help him with this project. Coincidentally, it was only patients with building skills whom Bailey thought would benefit from this occupational therapy. Sharon would often spend time with him at the site but, apart from providing sex, it is hard to imagine that she contributed any worthwhile assistance toward its completion. Bailey now suggested to Sharon that she should invest in his dream pro­ ject, and a deed of loan was entered into whereby Sharon lent Bailey $30,000. The debt was never repaid. Jan Allan has stated that Sharon was continually trying to give Bailey money, and she believes that the loan was merely a way of formalising this. Some of the nursing staff at Chelmsford were becoming increasingly concerned by Bailey’s extraordinarily unprofes­ sional behaviour. A new matron, Julie Smith, had been appointed in July 1976. She was young, aggressive and extremely professional, and within weeks she had begun to question Bailey’s treatment. This questioning resulted in a rowdy confrontation between the two, and, when she received no assistance from Dr John Gill, at this time a part-owner of the hospital and the effective medical administrator, she resigned. While she was there she told Sharon that Chelmsford was a hospital, not a boarding house, and ordered her to leave. Smith’s ultimate successor, Marcia Fawdry, who was employed as a nurse at the hospital, reacted in the same

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way. She told Bailey that Sharon should not be in hospital but Bailey replied ‘y°u can’t put her out because she’s a mess’. Fawdry’s irate response was, ‘Well, she wasn’t a mess 18 months ago, but she certainly is now!’ Bailey’s chaotic private life was becoming even more com­ plicated. He made overtures to another patient and a sexual relationship soon began. In December 1977 fate saw both these women admitted to Chelmsford at the same time, and Sharon and her rival had a public screaming match about Bailey in the wards of the hospital. In July 1977 Sharon realised she was pregnant. This came as a shock. Bailey had always assured his lovers that because of adolescent mumps his sperm count was so low that he was infertile, but Sharon claimed that Bailey was the father of the child. At Bailey’s insistence she entered Crown Street Hospital to have the pregnancy terminated. Bailey signed the required authority and told the resident medical officer that Sharon was ‘too emotionally disturbed’ to have the child. Sharon reluc­ tantly consented to the procedure and arranged for Bailey to pick her up when she was discharged. After a mix-up in arrangements Bailey failed to turn up, and Sharon was forced to return to her flat alone. She was in a distressed state and telephoned Bailey. She found him at Jan Allan’s flat and demanded that he visit her. Bailey complied and on his arrival a row ensued. Bailey telephoned Jan Allan and asked her to come to the flat. He told her to bring documents with her which would enable him to have Hamilton committed to an institution. Allan went to the flat but arrived without the documents. She was greeted by a scene of devastation. Furni­ ture was broken, the telephone was torn from the wall, and Sharon was waving a knife around in a threatening manner. Neighbours, alarmed at the uproar, had called the police. Calm was eventually restored and Jan Allan left. When the police arrived they were told by Bailey that there was nothing wrong, that he was Sharon’s psychiatrist, and that everything was now under control. Sharon visited her local doctor the next day and obtained a prescription for Tuinal. At this consultation she showed signs of having had a fight and she was badly bruised about the face and body. She told the doctor that she had been assaulted by a friend. She spent the next week staying with a friend, during which time she again attempted to take her own life. Bailey was called and yet again she was

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admitted to Chelmsford. Both Bailey and Jan Allan took Sharon to the hospital and she arrived in a deeply sedated state. He then proceeded to administer more sedation and, concerned that she might reveal to the nursing staff the reason for this admission, he did not leave the hospital until she was asleep. The next day Bailey received an urgent phone call from Matron Fawdry, who had been surprised to notice that Sharon’s breasts were swollen, and that she had vaginal bleed­ ing. As the sedation began to wear off Sharon apparently began to hallucinate, and she spoke of the baby she had lost. Matron Fawdry gave this information to Bailey and enquired whether or not Sharon had had an abortion. Bailey told her that such was not the case and that Hamilton must have been hallucinating. He told her that the sedation ‘was to be kept deeper’. Despite everything, Sharon seemed to bear Bailey no ill will. In October 1977 when she made her will, Bailey was the sole beneficiary. It is also interesting to note that in December 1978 Bailey’s other lover, whom Sharon had fought with at the hospital, tried to commit suicide after telling her sister that Bailey had asked her to leave her money to him. Sharon was back in Chelmsford in December 1977 for the treatment of deep vein thrombosis. This complaint is a wellknown side effect of poorly managed long-term sedation. She remained in the hospital for three days, and on her discharge left for a holiday trip to Hawaii. She was in good spirits when she left and her friends noticed that she looked better when she returned from Hawaii than she had for a long time. She called a friend, Dianne Absalom, and told her that she was no longer going to be Bailey’s patient. She also told Ms Absalom that she was embarrassed to go to another doctor because if she did she would have to disclose the details of her relation­ ship with Bailey. She was aware that this type of disclosure could result in Bailey being struck off the register. At the same time Sharon’s sister, Mrs Robyn Fennell, had visited Bailey and told him that she wanted Sharon to termi­ nate her relationship with him. Mrs Fennell made a note of the conversation she had with Bailey, which recalls that ‘he was extremely rude and told me that he was sick of the name Sharon Hamilton’. On 13 February, Bailey and Jan Allan had decided to go on

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a camping trip with a number of friends. As they were plan­ ning the weekend Sharon turned up and announced that she was going to join them. They were not pleased with this intrusion but acquiesced. The weekend was a disaster and ended in a drunken row between one of the couples. Sharon was extremely jealous of the fact that Bailey had spent the night with Jan Allan, and was pleased when the party broke up and Bailey agreed to drive her home. On the return journey they fought again and Bailey struck her. The precise events of the next two days are a matter of speculation, but at their end Sharon Hamilton was dead. Bailey said that on the evening of 15 February he had received a call from Sharon and, as a consequence, she had gone to his surgery. She accused him of killing her baby, which, had the pregnancy not been terminated, would have been due at this time. Once again they had a violent row. Bailey called Jan Allan, he gave Sharon a dose of valium, and Allan drove her home. Once there Allan confided in Sharon that she had had enough of Bailey’s nonsense and that she was going to leave him. She assured Sharon that her decision to leave Bailey had nothing to do with Sharon’s relationship with him, but was due entirely to her own realisation that there was no future in it for her. Allan then went home. The next morning Hamilton’s body was found. She had taken an overdose of Tuinal. The mystery surrounding the last hours of Sharon’s life is increased by an account of the evening given by Sharon’s next door neighbour, Mrs Daisy Gillard. Mrs Gillard remembers that particular night because of two unusual events. In the early hours of the morning her usually placid dog growled and woke her up. Once awake, she realised that the reason for the dog’s strange behaviour was the sound of a loud disturbance in Sharon’s flat next door. She heard raised voices and furniture banging and sounds of a fight. She also heard the security door, which was positioned just outside her flat, close. This could only have been caused by someone either arriving at or leaving Sharon’s flat. Two hours later a ferocious storm broke and she went onto her balcony to rearrange her pot plants. While there, she noticed that the light was on in Sharon’s flat. She was not surprised by this because she thought that Sharon also must have been woken up by the storm. At 7.45 a.m. she heard the security door open again, and thought

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that Sharon must have been going to work. Fifteen minutes later two ambulance men knocked on her door and told her that they had received an emergency call that someone next door was sick. She expressed her surprise as she thought she had heard Sharon leaving for work. The ambulance driver asked if he could climb over her balcony into Sharon’s flat and she agreed. He soon returned through the front door and told her that Sharon was dead. In light of the disturbance that she had heard she was astounded to learn that there was no sign of anything out of place. Sharon was stretched out on the floor wearing a black negligee and blue slippers. Her arms were by her side with her feet together. Beside the body were two notes simply addressed to ‘Jan’, and an incomplete will in which she pur­ ported to leave everything to Jan Allan. The will had been torn in two. Prior to Sharon’s death Mrs Gillard had often seen Bailey coming and going from the flat at strange hours and she is sure that Bailey had his own key. During the following week Mrs Gillard heard noises next door. As she knew that the flat was supposed to be empty, she became frightened and went to stay with her son. Bailey did still have a key to Sharon’s flat and, a few days after her death, he took his gun and, at about midnight, went there. He sat there alone. He opened a 50-year-old bottle of claret he had been given as a gift and drank it all. In a drunken rage he wrecked the flat. He later told people that he had tried to shoot himself . . . ‘but I was too pissed even to do that’. He said he aimed at himself but missed, firing the pistol into the wall. It scared the neighbours, including a police superintendent. Bailey left and staggered into the parking area. He reversed his car, crashed into a garage and, at 3 a.m. drove to Jan Allan’s flat. ‘He was blind drunk,’ she recalls. He was waving the gun around menacingly and, while a friend who was staying with Jan Allan rang the police, Allan grabbed the gun from him and hid it in a kitchen drawer. ‘I talked the police into taking him to Royal North Shore Hospital. I didn’t think he should be arrested, but it may have done him the world of good in the long run,’ she said. At the hospital, Bailey was examined by two psychiatrists before being allowed to go home.

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What happened during the night of Sharon’s death is a matter for conjecture. Two inquests have been held into Hamilton’s death and both have returned a verdict of suicide. At neither inquest were the sordid details of the relationship between Bailey and Hamilton introduced into evidence, and in both hearings Bailey gave false testimony. He denied that he was in any way financially involved with Sharon and he claimed that he had ceased to treat her some six months earlier. The details of his debt to Sharon are now at large and the admission records of the hospital clearly show that Sharon had been admitted under Bailey’s care only six weeks earlier. Bailey was the sole beneficiary of Sharon’s $100,000 estate. Most psychiatrists would immediately refuse to accept a bequest from an emotionally unstable patient, especially if it constituted the sum total of the deceased estate. Bailey’s response was different. He simply told the press ‘I’m embarrassed!’ Jan Allan told the inquests how she had returned home from Sharon’s flat to find Bailey waiting for her drunk. Bailey had said that he had been alone at Allan’s flat all evening. In his finding of suicide after the second inquest on 16 March 1979, the coroner, Mr J. B. Goldrick, said he accepted Allan as a witness of truth. He said there had been an exhaustive investigation into Sharon’s death and he was completely satis­ fied she had been alone for some hours that night, in a seri­ ously disturbed state of mind, and that she had known what she was doing when she took her own life. Goldrick said he found nothing in Daisy Gillard’s evidence to raise doubt or cast suspicion on Jan Allan’s evidence. Sharon Hamilton’s family has never been satisfied that the mysteries surrounding her death have ever been adequately explained, and while they are not prepared to claim that there was any foul play, they believe that Bailey suggested to Sharon that she was causing him too much trouble, that she should do the right thing and cease to have anything more to do with him. Her family believe that in Sharon’s weakened emotional state this could only mean one thing, and Sharon obliged. Sharon Hamilton died on 15 February 1978. One week later Jan Allan told Bailey that she had had enough. She had contemplated leaving him for some time and had begun her friendship with Doug Dinnerville, a carpenter who had car­ ried out some work for Bailey at Mandala. Bailey’s reaction

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was a mixture of jealousy, anger and insult. He could not accept that she would leave him for anyone else. After many years as a heavy smoker Bailey decided to stop and, as a consequence, his usual quick temper worsened. He substi­ tuted alcohol for tobacco. In a rage he telephoned Dinnerville. For the first time in his life Bailey had been rejected. He had promised Allan that he would marry her after his daughters turned 16, but six years had passed since then. He took to phoning and begging her to return. This was to continue for the next two years. It was apparent to everybody who knew him that Bailey was on the verge of a nervous breakdown. He was morose and at times would weep openly. Bailey had been effectively separated from his wife for nearly ten years although he continued to live at home. Bailey’s sister and brother-in-law advised him that the only possible way he could re-establish his relationship with Allan was if he finally left his wife, so he did. He telephoned Allan and told her that he was moving out and asked her to join him. She refused. Bailey was now obviously ill and in March 1978 his sister took him to her home in Canberra. He remained there for a short time and then returned to a unit he had rented in the harbourside suburb of Drummoyne. It was clear to his friends that Bailey could not function without the support of Allan and they begged her to return to him. She again refused. Although Allan and Bailey had ended their relationship she continued to work as his nurse and receptionist, but the atmosphere was extremely tense. In a fit of rage she was sacked and in a childish display of pique Bailey refused to write her a reference. Two weeks later he had a total breakdown. At 5 a.m. one morning he returned to his wife, told her he had a viral infection, that he was depressed, and that he needed treatment. Mrs Bailey called his sister and Dr David Howell, the family physician. Bailey was agitated and demanding, so a private nurse was also employed. Howell called Allan, and Mrs Bailey contacted Herron and Evan Davies. Herron decided that Bailey should receive psychiatric treatment and suggested Deep Sleep. It was agreed that it would be better if Bailey was not treated at Chelmsford and attempts were made to book him into another hospital. A former matron at Chelmsford, Sandra Robson, was at this time the matron of another private hospital but she refused to admit Bailey for Deep Sleep.

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Chelmsford was selected as the only alternative but it was decided that Bailey should not be told. He was admitted to Chelmsford on 4 April, 1978, under the name of Harry Lee. Prior to taking him to Chelmsford, Herron gave Bailey an injection, and when he arrived at the hospital he was unconscious. It was, of course, impossible to hide the identity of the new patient and the nurses were rather embarrassed at the thought of nursing him. Herron was much more cautious about the administration of Deep Sleep to Bailey than either Bailey or he had been when they treated other patients. Bailey was given a full physical examination before he was sedated; his heart was checked with an electro­ cardiogram, a procedure, which, as we have seen, was thought to be imperative by Professor Joseph if any form of prolonged sedation was to take place. Herron also decided to keep the amount of drugs given to Bailey at a minimum, and the stan­ dard drug regime was not used. Harry Lee’s hospital notes have disappeared, but Marcia Fawdry, who was matron at the time, recalled at the Chelmsford Royal Commission: We were just a little more careful I guess. I shouldn’t say things like that because you’re careful with everyone, but knowing he had a cardiac history, feeling guilty that he was in his own hospital, [meant] I suppose, feeling a certain sense of responsibility about that. But certainly he was kept well sedated. He never knew where he was. Matron Fawdry kept well out of the way because she was concerned that Bailey might wake and recognise her. She was also concerned about the emotional strain that Herron was being put under by treating Bailey: Imagine if [Bailey] died, imagine. Not only the professional trouble Herron would be in, but his own emotional thing because he obviously thinks a lot of the guy. We rang [Herron] about it and we said, “For God’s sake, give him 10 [ECT] quickly and let’s get him out of sedation”, and John [Herron] said, “You don’t think I want him down longer than he has to be . .. God, I don’t want him carking it or anything like that!” Bailey was still unconscious when he was transferred to

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another private hospital, The Seventh Day Adventist Hospital, which was situated near to Chelmsford. As soon as Bailey had recovered he immediately returned to work. Matron Fawdry thought that he still looked ‘bloody awful. He had lost a lot of weight. He looked drawn, lack­ lustre. He really looked like a psychiatric patient.’ He had no idea that he had received Deep Sleep, but thought he had had a course of ECT. He was anxious to find out whether the Minecta had been used, and after he was assured that it had been he told Fawdry, ‘Oh, that’s fine. I’d be some sort of a prick if I couldn’t expect the treatment I gave to other people wouldn’t I?’ Bailey’s return to work produced another bizarre episode. He had sacked Allan and her assistant, so Mrs Bailey had stepped in to fill the breach. She called Allan and asked her if she would be prepared to help her to interview possible job applicants. ‘Mrs Bailey didn’t want me putting on another girl who I thought was extremely good, she would have looked too attractive for Mrs Bailey,’ Allan told the Royal Commission.

CHAPTER 8

SEE NO EVIL

At the conclusion of the Carter inquest in 1967, Bailey should have considered himself lucky to still be practising medicine. It is now clear that Bailey had given misleading evidence about the nature of his treatment at the coronial inquiry. The find­ ings at the hearing, however, had drawn attention to the fact that there appeared to be an unreasonable amount of auth­ ority delegated to the nurses at Chelmsford, so, while the Coroner did not ‘blame’ Bailey for Carter’s death, the fact that there had been an official hearing which involved Deep Sleep should at least have sounded warning bells. It was inevitable that Bailey’s idiosyncratic manner of prac­ tising medicine should at some time come under the scrutiny of the various government departments responsible for the administration of medical practice. It was also inevitable that it would have an impact on all those fellow professionals upon whom he relied in order to carry out his various treatments. The whole Deep Sleep programme depended for its con­ tinued operation on a breach of the regulations governing the dispensing and prescription of dangerous drugs. The standard drug regime, written as it was in the back of the ‘Bailey Book’, did not satisfy the legal requirement that patients may only be given dangerous drugs if they are specifically prescribed. During the first five years of the programme patients were simply sent by Bailey to the hospital and Bailey’s nurse would phone, book the bed, and give oral instructions to the office that the patient was to receive ‘Dr Bailey’s special treatment’. Treatment would begin the moment the patient arrived and at no point would a formal personal drug prescription sheet be completed. It was not until 1968 that the authorities had any idea, or were in any way interested, in the treatment that was being provided at Chelmsford. In 1968, however, it was necessary for Chelmsford to have its licence renewed. As was the usual practice, a representative 81

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from the Health Department visited the hospital. The Health Department official, Miss Patricia Larwood, was initially con­ cerned about the discretion given to the nurses in the pre­ scription of dangerous drugs. She immediately realised that Bailey was not conforming with the requirement that each individual drug regime be signed by him, the prescribing doctor. She was also concerned that the very general nature of the doctor’s directions resulted in the hospital acting as a chemist, yet providing dangerous drugs to patients without prescriptions. While it is often necessary for patients to receive medication in hospital, private hospitals, such as Chelmsford, must either have prescriptions filled at a local pharmacy or employ a resident pharmacist. She was also con­ cerned that contrary to regulations, drugs of addiction were stored with other medications. This meant that drugs of addic­ tion were too readily accessible to unauthorised persons. Bailey was present during Miss Larwood’s visit, and he was able to convince her that his special programme required the variation in the application of the law, and that the law would be complied with eventually because he signed each treatment sheet when he visited the hospital. Although she had her doubts Miss Larwood recommended that the system be allowed to continue. All the same, Miss Larwood concluded that Bailey was ‘meticulous about writing up treatment but would not sign the entry’. The authorities at this stage had every reason to assume that Bailey would react in the same way as other medical practitioners when ‘counselled’ by mem­ bers of the health bureaucracy. Counselling is seen as a warn­ ing that a particular form of behaviour is unacceptable, and, in most instances, this alone is sufficient to ensure compliance. The Health Department ‘believed that after the visit Bailey would sign each entry’. Shortly after the inspection by Miss Larwood, Bailey did modify the way in which his system of drug prescription operated. Instead of writing the standard drug regime in the back of the ‘Bailey Book’, be prepared a standard drug sheet. This was designed so that on each admission it only required the particular patient’s name to be filled in. When Bailey attended the hospital he would sign at the bottom of each sheet, which, when done, complied with the legal require­ ments. When the head of the Poison’s Branch of the Health

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Department, Mr Robert Dash, had visited Bailey in July 1971 as a follow-up to another inspector’s report, Bailey had pro­ duced the standard drug sheets and convinced Dash that the new scheme was appropriate for this particular situation. In a report which he wrote at the time and which was later ten­ dered at the Chelmsford Royal Commission Dash described Bailey as being ‘open and frank’ and that the meeting was very pleasant. Bailey assured him that the forms were completed in compliance with the requirements when he attended the hos­ pital, and this meant that there was only a day’s delay. Bailey, however, could not resist embellishing the facts. He told Dash that he had ‘been providing the treatment exclusively for 12 years’. This of course would have meant that the procedure had started in 1959 instead of 1963. He also told Dash of his plans for Mandala: He said that this form of nursing requires considerable nursing skill and experience, and for this reason he has always sought to have a stable nursing team in which he could confidently rely. Until recently this had been pro­ vided, but there had been a change in ownership of the hospital. The new owner had invested a considerable amount of money in the alterations and extensions, some of which Dr Bailey considered detrimental to his patients, and had failed to provide some facilities which he considered desirable, if not essential. He instanced the laying of parquet floors in the wards, which he considered unnecessarily noisy, instead of instal­ lation of air conditioning, which he considered essential to maintain the body temperature of those patients who were under narcosis. As a result Dr Bailey stated that he has found it necessary to commence his own hospital, which is at present being prepared by a conversion of an existing building at Haberfield. He showed me the plans for the new hospital which he expects to be operating within three months. He indicated that a licence to distribute and supply drugs of addiction would be sought when the hospital was completed. At the time that Bailey made this statement to Dash, Mandala was still an old wrecked house. Bailey had made no

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attempt to obtain any finance to complete his ‘dream’, nor had he any intention of permitting anybody other than himself to control it. It may well have been that Bailey’s objection to the expansion of Chelmsford rests in the fact that he would have to share its facilities with other doctors and the proprietors would therefore no longer be entirely dependent upon him for their profit. Despite his objections, in 1972 Chelmsford received permission to expand from 15 beds to 40 beds. During the renovations a special eight bed ward was con­ structed to be used entirely by Deep Sleep patients. And, as Bailey may have feared, the increased size of the hospital meant that the proprietor took steps to encourage other psy­ chiatrists to hospitalise their patients there. Nevertheless, from this time until 1978, when the hospital ceased to accept Bailey’s patients, over 50 per cent of all patients who attended the hospital for Deep Sleep or otherwise, were sent there either by Bailey or Herron. A more sinister reason for his objection to the expansion may have been that with other doctors admitting their patients to the hospital, the exact nature of his treatment would have become public. On this later point Bailey need not have had any fears because for nearly nine years other medical practitioners walked past the closed doors of the sed­ ation ward. The introduction of the standard drug sheet is interesting, because the quantity of drugs which were now prescribed stipulated half the amount of Tuinal that had been given to Graeme Carter before his death in 1967. Carter had received 2400 mg of Tuinal in a single 24-hour period, but the new regime provided that the patients should receive only 200 mg every four to six hours. This meant that the dosage range was now between 800 mg and 1200 mg within each 24-hour period. The dose expressed on the sheet, however, was less than that which was habitually given and shows that Bailey was aware that the quantities that he was prescribing went beyond those which would have been approved, as the patients’ nurs­ ing notes confirm. Visits to the hospital from the health bureaucracy could not solve the problems. During one, again in 1971, the inspector was concerned by the facts that patients were given a nine-day supply of drugs when they left the hospital, and that these

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were given without a doctor’s prescription. But she was assured that the problem of post-hospital supply would be rectified. Herron has since described the drug sheets as ‘a farce’ but they were only farcical because those who used them regarded them as such. A typical standard drug sheet, prepared in 1971 and approved by the Health Department, was as follows: Tuinal 200 mg 4-6 hourly Neulactil 10 mg 6 a.m. and 2 p.m. Seranace (1.5 mg tabs) 3-6 tabs 10 a.m. and 6 p.m. Cogentin 2 mg IMI* prn* Sod. Amytal 500 mg IMI prn Atropine 0.6 mg prn Placidyl 200-500 mg prn When Lightened Mylodorm Sustrels 3-6 tabs 6 a.m. daily Neulactil 10 mg bd* for 48 hours Tuinal 200 mg nocte* Mogadon lVz tabs nocte *(IMI means intramuscular injection, ‘prn’ means when the nurse thinks it is necessary, ‘bd’ means twice a day, and ‘nocte’ means at night.) These drug sheets were a farce not only because they did nothing other than satisfy a bureaucratic requirement, but also because they were not adhered to. The nursing notes (as distinct from the signed drug sheets) of this typical patient also showed that he received a maximum dose not of 1200 mg of Tuinal each day, but of 2400 mg each day from the moment he entered the hospital. Between 1971 and 1975 there were five variations on the theme of the original standard drug sheet. At no time did Bailey bring these changes to the attention of the Health Department. The drug sheets were simply changed to rep­ resent what actually happened and from this time onward read ‘Tuinal 200-400, 4-6 hourly’. To add to the farcical nature of this arrangement, irrespective of which drug sheets were being used, all patients received the same doses. During this same period there had been a complaint from a pharmacist that a prescription had been presented at his shop signed by Bailey, but clearly filled in by someone else. This

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resulted in a formal investigation and it was discovered that, prior to going on a trip overseas in February 1972, Bailey had signed a number of blank prescription forms which he had directed a nurse to fill in for patients who requested repeat prescriptions. It was clear that Bailey had committed offences both by signing the blank forms and instructing that the scripts be filled out in his absence. The authorities, however, decided that they did not want to prosecute. Once again Bailey’s rejec­ tion of legal requirements had not caused him anything other than a small amount of personal annoyance. Bailey’s breach of various regulations had now caused a number of government departments to investigate his activi­ ties but, fortunately for him, there was no administrative system in place to enable these disparate organisations to pool their information. Had this been the case, it would have become apparent that Bailey was a rogue practitioner who had no intention of obeying the statutory requirements imposed on all doctors if these requirements interfered with the way that he wanted to practise medicine. Bailey was also lucky that it was official Health Department policy that there should be as little intrusion as possible into any doctor’s choice of the appropriate treatment for patients. Many of the hospital inspectors were nurses and, probably because of their early training, they did not see it as part of their function to question the medical judgement of a doctor. This official policy had some strange consequences. In 1969, for example, a former nurse at Chelmsford made a formal complaint to the Health Department in which she claimed that the treatment being carried out at Chelmsford was exper­ imental. She also complained that Dr Herron, who was employed by the Health Department, was spending more time at the hospital than departmental regulations permitted. The head of the Department instituted an investigation because he believed that Herron was in breach of his employ­ ment contract and this complaint resulted in a Public Service Board Inquiry and subsequent hearing, in which Herron was severely reprimanded. Herron undertook to spend no more than three hours per week in private practice, although, as he has since admitted, he did not comply with the Public Service Board stipulation. At no time was the complaint of exper­ imental treatment investigated.

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Bailey’s reaction to ‘interference’ was not restricted to his medical practice. He carried out renovations on his home in Leichhardt without council permission; he obtained detona­ tors illegally because he wanted to dig his own swimming pool; he displayed a human brain on his desk in contravention of the law restricting the storage of human parts; he encour­ aged Herron to breach a public service directive; and he thumbed his nose at regulations restricting the storage and distribution of dangerous drugs. The same lack of questioning and checking the facts occurred when Bailey decided that he could re-establish his reputation as a psychiatric research scientist by publishing a number of articles in the most prestigious medical journal in the country, The Medical Journal of Australia. He had long since regarded himself as the leading authority in psychosurgery, and he continued to believe that this method of treatment should be the one of choice for a large number of psychiatric problems, rather than as a last resort. His research protocol seemed simple: select patients at random, carry out psychological assessments, carry out some ‘conventional’ psy­ chiatric treatment, declare the treatment a failure, refer the patients to a surgeon who was prepared to carry out the surgery, make another psychological assessment, declare the operation a success, and publish the results. The whole scheme depended on a compliant and trusting surgeon, an unconventional psychologist, compliant and uninformed patients, and Bailey. There was no shortage of patients, and, as a matter of routine, he referred them to psychologist Dr Evan Davies for a pre-treatment psychological assessment. These assessments were unusual. Davies had put together a battery of tests to measure a patient’s psychological problems. They were designed to measure motivation, anxiety, affection, aggression, intelligence, family relationships, and depression. Bailey, although he had no expertise in the area, had suggested to Davies that the normal battery of tests could be abbreviated and that these shorter tests would satisfy the requirements of accuracy. In the report of the Chelmsford Royal Commission, the Commissioner found that the tests used by Davies did not have adequate levels of certainty. He found, ‘ . . . the consistent pattern of variation or even inconsistency . . . left me with a

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degree of uncertainty about what the report was intended to mean, which confirmed my view that they [the tests] were of limited use.’ In combination with Bailey’s idiosyncratic method of recording case histories, the psychological testing was designed to measure the effectiveness of any psychosurgery. Bailey pub­ lished the results in August 1973 and claimed remarkable success for his operation. He also claimed that the surgery that he was recommending was totally different and more sophisti­ cated than the by-then discredited leucotomy operations. Leucotomy was an operation on the brain designed to sever that part of the brain which caused the psychiatric problem. The lack of knowledge about the precise part of the brain which is responsible for our actions, and the inability of sur­ geons to completely restrict the damage to a sufficiently small area, could result in horrendous side effects. Bailey maintained that psychosurgery could be a treatment of choice for manic depressive illness and obsessive compul­ sive illness, for psychosexual exhibitionism and compulsive antisocial behaviour, and could be a possible substitute for gaol. He admitted that it was useless for treating schizophrenia but was ‘a most potent and effective technique for removal of disabling levels of anxiety, and that long standing phobic anxiety is easily relieved by the procedure’. He concluded that there was ‘no intellectual or personality deterioration follow­ ing the operation, and social awareness and responsibility are unimpaired’. He advised that there must be careful follow-up and reassurance, and that situational problems must be moni­ tored. Dr John Ellard, a former president of the Australian and New Zealand College of Psychiatrists, wrote in a report, which was later presented as an exhibit at the Chelmsford Royal Commission, that he had been critical of Bailey’s involvement in psychosurgery, and addressed the problems that Bailey’s peers had in openly criticising his work: We were dependent on picking up scraps and remember, too, that he had published at least once, and perhaps twice, on his psychosurgery in The Medical Journal of Australia with eminent referees, and had them accepted. It looks black and white now, but it was not then.

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It is surprising' that Bailey’s colleagues should have been prepared to accept these articles as authoritative, and even more surprising, that, with two notable exceptions, his col­ leagues should have treated them as an indication of Bailey’s depth of learning. He claimed 99 per cent of all patients treated improved, but at the same time said that the operation was not suitable for schizophrenia, a common mental disorder. But he couldn’t claim that the treatment didn’t work on schizophrenics unless he had tried it, yet if he had, and he found that it wasn’t successful, he could not have legitimately claimed a 99 per cent overall success rate. In any case a 99 per cent success rate for any sophisticated medical procedure is unheard of, yet his claim was not queried. He reported that the instances of death and ‘bad results’ were low, yet of the nine typical cases studied, one patient had died. An 11 per cent death rate is hardly insignificant. According to the article, yearly post-operative assessments had been made, and these confirmed his research findings. An examination of the records shows this to be untrue. There was rarely any follow up at all. Prior to each operation patients had supposedly received psychotherapy. In fact he prevented his patients from attending any group therapy sessions while they were at Chelmsford. His notes certainly give no indication that this type of therapy was used by him to any appreciable extent. He derogatorily described it as ‘talking therapy’. Prior to the publication of any article in The Medical Journal of Australia it is submitted to referees by the editorial staff. Bailey’s article was sent to Professor Les Kiloh, Professor of Psychiatry at the University of New South Wales, who read it, concluded that it was scientifically flawed, and rec­ ommended that it not be published. He told Dr John Sydney Smith, then a lecturer in psychiatry at the University of New South Wales, of his surprise when it appeared a few weeks later, and his even greater surprise when he saw that the number of patients who had been the subject of the research project had risen from less than 100 in the article that he had read, to 150 in the article that was subsequently published. It cannot be discovered if the article was sent to other referees prior to publication. Following the publication of the article, two letters critical of it appeared in the Journal. They were written by Dr S.E. Williams, then on the staff of the Psychiatric Research Unit at

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Callan Park (the successor of the CSRU), and Dr Sydney Smith. Williams analysed the statements made by Bailey about the nature of the operation and its technical detail, and con­ cluded that it was no different from existing leucotomies. Smith agreed with Williams and added that there were internal inconsistencies in the article. The consequences of Williams’ and Smith’s letters were dramatic. For example, the number of psychosurgical opera­ tions being carried out at Prince Henry’s hospital dropped from about 40 per year to two per year. Smith recalls Dr Dowling, Bailey’s psychosurgeon, confiding in him, and explaining to him that he was extremely sad that Bailey had let him down. As with all surgeons in this field he had been totally dependent on the psychological assessments given to him both before and after the operation by the attending psychiatrist, that is, Bailey. The publication had some vital consequences for Bailey because publication itself provides its own aura of authenticity and accuracy. It provides a vehicle for legitimate advertising, and keeps the name of the author in the mind of those who are to be the source of potential patients. By the end of 1973 the very existence of ‘brain surgery’ was exciting much public interest in Australia and overseas. In March 1974 the Australian Broadcasting Commission put to air a ‘Four Corners’ programme in which the current situation with regard to psychosurgery was discussed. Bailey was asked to participate, but he declined, saying to producer Gordon Bick that ‘he had nothing to gain by appearing . . . ’ Those on the panel, including Bailey’s long-time critic Pro­ fessor Maddison, were scathing about Bailey’s work and, for the first time in his career, Bailey received a uniformly bad press. There were allegations that Bailey was actively soliciting patients; that he had convinced a number of members of the Sydney judiciary that it was better for some convicted crimi­ nals to have his operation than to go to prison; and that the operations were being carried out without patient consent. Dr Eric Marshman, a psychiatrist at Gladesville Hospital, told us of an instance of the latter: an involuntarily committed patient, suffering from a manic depressive illness, was removed from Gladesville Hospital by his relatives and taken to Prince Henry Hospital to be prepared for surgery. Legal proceedings had to be threatened before the patient was returned. Bailey had decided that the operation should go ahead, even though,

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until the patient was removed from the hospital, he had never even seen him. In the aftermath of the ‘Four Corners’ programme a number of psychiatrists, who believed that surgical procedures could play some limited part in the treatment of severely disturbed patients, organised a two-day conference on the subject, which they entitled ‘Psychosurgery and Society’. The conference was largely devoted to a technical analysis of the merits and demerits of psychosurgery, but it was inevi­ table that the general circumstances surrounding its perform­ ance were raised. Gordon Bick was on the panel of one of the sessions and at this session, the following exchange took place: Dr E. Davies: “I am part of a team led by Dr Bailey ... I would like to ask Mr Bick if it is not true that he prepared his television presentation and then asked Dr Bailey whether or not he would be willing to comment on the material, and that it was under those circumstances that Dr Bailey refused to participate? ” Mr Bick: “No, it is certainly not true. In fact Dr Bailey was the person I contacted before any other material was pre­ pared for the programme. He is after all the person respon­ sible for most psychosurgery performed in Australia and without him I felt there would be no programme. When I approached him initially he said he wanted time to think about it. After one week I went to see him, had a lengthy conversation with him and he considered appearing on the programme. He rang up about one week later and declined to appear. After preparing the whole programme without him I offered him the further opportunity of appearing. He declined.” It is hard to imagine the Bailey of 1960 refusing an oppor­ tunity to tell the world of his great achievements in the fast developing science of brain surgery. The reason he didn’t, however, seems obvious. Bailey had studiously avoided putting himself into a position where he could be questioned by anybody who knew anything about the subject he was discuss­ ing, and the prospect of having both his theories and his procedures openly debated, was more than he could take. Better to pretend offence and not appear, than to be humili­ ated before the whole psychiatric world, and ultimately the

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public at large. Bailey could throw a tantrum and threaten the nursing staff if they did not follow his demands, but he was not prepared to be confronted by his peers. He retreated to the non-medical world where he was comparatively safe, and where, because of the strange application of medical ethics, his colleagues would not undermine his still largely unchallenged reputation. Since 1963 Bailey had delegated the administration of ECT to Herron but Herron was now too busy to carry out all Bailey’s work. Herron in May 1963 therefore subcontracted some of this work to Dr Ian Donald Russell Gardiner. Gardiner was employed as a psychiatrist at North Ryde Psychi­ atric Hospital, but he had failed the theoretical examinations which would have entitled him to receive his Diploma of Psychiatric Medicine. Gardiner was known at Chelmsford as the ECT man. He would call in on the way to work about three times a week, administer ECT to a list of patients, and proceed on his way. Gardiner gave evidence that it was not part of his duties to make any independent assessment of the patients in order to decide if they were well enough to receive the treatment. Bailey was so unconcerned about Gardiner’s role that Gardiner had been providing this service for a number of years before he was even introduced to Bailey. Bailey’s idiosyncratic methods were only accepted as normal by those on his team, but when Chelmsford changed hands in 1973, another medical practitioner became involved. Chelmsford was purchased by a syndicate of investors which included Dr John Ewan MacDonald Gill. Chelmsford was showing a good return for investment and active steps were taken to interest other psychiatrists in the use of non Deep Sleep facilities. These facilities were of a high standard and easily met with the Health Department regulations. Gill took great pleasure in the status that being a hospital owner carried with it, and he visited Chelmsford regularly. Apart from Bailey, Herron, and their new assistant Dr Ian Gardiner, Gill was the only other medical practitioner to have spent any appreciable time in the Deep Sleep ward. With his medical training and as proprietor of the hospital he had the oppor­ tunity to assess the regime and make an independent judge­ ment of it. His position empowered him, if he found it unacceptable, to force Bailey either to terminate the treatment or take it elsewhere. Yet Gill seemed to be overawed by the

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presence of Bailey and he didn’t appear to question his cava­ lier attitude toward dangerous drugs and nursing require­ ments. It may have been understandable if Gill had restricted his admiration to tolerance of what Bailey was doing but he tried to copy the treatment. Gill had seen Bailey prescribing Deep Sleep for a host of strange symptoms. Patients had been ad­ mitted to Chelmsford and Deep Sleep for weight loss, post­ partum depression, anorexia nervosa, impotence, drug addic­ tion, alcoholism, examination nervousness, and excessive smoking. While Gill may have held Bailey in awe, the feeling was not reciprocated. By the end of 1967 Bailey had lost ten patients, and between 1967 and the end of 1974 there were nine more deaths at Chelmsford Hospital. Each was one of Bailey’s Deep Sleep patients. Bailey discovered that the best way to avoid an inquest was to state the cause of death as being something innocuous, and not to mention that the patient had been unconscious within 24 hours of dying. An extra safeguard, of course, was to remove all the patient’s records and all the nursing notes. While there is no evidence that Bailey himself destroyed any patient notes, it is only the notes of deceased patients that are missing, and his reaction to Matron Edwards in 1964 when she had tried to record a death, would be consistent with this action. The patients who died as a result of Deep Sleep Therapy during this period ranged in age from 25 to 68. It appears that Chelmsford patients had a propensity for ‘heart attacks’ as each of the deceased is recorded as dying from ‘coronary occlusion’ although there is no evidence that any of these patients had any history of heart disease. Bailey’s regime was dangerous at best, but unacceptable for any patient who had any indication of physical ill-health. The Deep Sleep programme imposed enormous strain on the nurses. They were required to carry out tasks and make decisions about medical matters for which they were not qual­ ified. Bailey had unilaterally changed the traditional relation­ ship between doctor and nurse, but he failed to provide them with either the information or the support they needed to fulfil their new role. They were also obliged to carry out physical tasks which were both onerous and unpleasant. The

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unconscious patients were inevitably incontinent but catheters were not used because of the risk of infection. Patients often lay in their own urine for several hours. This led to urine soaked beds and a constant unpleasant smell. Patients were fed through a tube inserted into their noses. Constipation was common, although this does not mean that faecal inconti­ nence was uncommon. Bed sores are a constant threat when patients are immobile and this meant that they had to be physically turned at regular intervals. Yet, with some horren­ dous exceptions, the nursing notes indicate that bed sores were surprisingly uncommon. Even so, one former patient recalled: I was having hallucinations about a lot of coloured ribbons and trying to climb out through them and finding the world again. I woke up in a bath tub and two nurses were bathing me. I felt really dirty. One of the nurses said, “My God, look at her knees.” I looked down and they were joined together. The nurses gently pulled them apart. The patient still retains the scars on the inside of both knees. She remembers the nurses putting cream on them and of her being unable to walk: They took me in a wheelchair back to the bed and told me I had to eat something. I had some soup or something but I could not walk. My husband was still there and he came and sat by the bed with me and the next day he helped me to walk. If he had not been there I do not think I could walk today. He helped me to walk a bit further each day until finally I put one foot in front of the other on my own. Bailey’s habit of visiting his patients at Chelmsford during the late evening also put strain on the nursing staff. He demanded that all patients who were conscious or who had finished their course of Deep Sleep should be out of bed when he arrived and he held his consultations in the matron’s office. In order to comply with this demand patients were often forced to remain awake for long periods of time because nobody knew exactly when Bailey would arrive. When he did arrive he was often dressed informally ‘wearing flowing Hawai­ ian coloured shirts’. On other occasions he looked as though

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he had just completed a round of golf, and sometimes he appeared wearing his dinner suit. Marcia Fawdry, who was matron from January 1977 to July 1978, and who for many years worked on the night shift commented, ‘ he was sometimes a bit under the weather when he came up ... he was not drunk . . . Euphoric I suppose would be a nice word for it.’ His late night arrivals resembled a royal visit. He would sweep into the hospital, march straight into the matron’s office, and summon the patients one by one into his presence. We were sitting along the hallway near the entrance. Sitting on either side of the hall. Most of us took our ashtrays because we smoked. We would wait a couple of hours and then see him in a room. There were times when Bailey would not arrive at all and the patients were put back to bed. Emotionally disturbed patients are often extremely anxious to see their doctor and the nurses were forced to deal with the stress that Bailey’s failure to appear created. Matron Smith was in constant conflict with Bailey about this. She recalled that she would phone him and say: “You have got to come. People have been sitting around waiting to see you”, and I would tell him that some people were under sedation for 12 days. Sometimes he would say, “I will come”, and I would say to the patients, “Your doctor is coming today. Sit up tonight. He will be here”, but he would not come, and there were times when it would be three or four weeks before these people were seen by their psychiatrist, Dr Bailey. Matron Smith further recalled: So many times he would say he was coming and they would sit up and wait, you know, until one o’clock sometimes. You would hold back their sedation and that could go on night after night. The next day he would ring, and I would say “you didn’t come and the patients sat up all those hours waiting for you”, and say for example, “Mr Y desperately wanted to talk to you, and he needs to talk to you”, and he

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Bailey also thought that others should be prepared to fit into his eccentric working hours. For many years he had established the routine of visiting the matron's flat, which adjoined the hospital, when he arrived to complete his rounds. This was apparently accepted without demur until Julie Smith became matron in 1976. She remembered that: Prior to that second visit he had come at night, and came around to my flat. He was bashing on the door, demanding for me to let him in, and I just didn’t answer at all. But the next day, when I was back on duty, I rang him to give a report, and I said, “If you want to see me my working hours are 8.30 to 5.30 and I would be happy to talk to you about anything then”, and just left it at that; and he did come again during the day after that phone conversation, and that’s when he went through the tirade again about how good deep sedation therapy was. Until Matron Smith’s arrival at Chelmsford nobody had thought that it was within their power to question Bailey’s modus operandi. She has described her short six months stay at Chelmsford and her relationship with Bailey as follows: We did not get along . . . because I would ring and say, “Your patient has an infection and I want you to come up and see him”, but he would not come. As it went on week after week our relationship got worse and worse because he would yell at me and I at him. I said, “It is all right for you sitting there in Macquarie Street. I am here with the patients. You get yourself up here and look after them.” There came a stage after that that I stopped ringing him, and I would review the position and make decisions on my own, and then tell him I had taken people out of sedation and stopped medication. During her time as matron, Smith attempted to convince the hospital owners that the maintenance of Bailey’s programme was not in their best commercial interests. She pointed out that it was rumoured that his treatment was crazy

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and that other psychiatrists would not send their patients to a hospital which permitted this to happen. After one particu­ larly acrimonious row between Smith and Bailey, Bailey threat­ ened to take all his patients out of the hospital. In evidence at the Chelmsford Royal Commission Smith recalled: Dr Gill and I did discuss it. Dr Gill was very concerned, but laughing, too, about it all. At the time Dr Bailey said, “I am going to get all my patients on sedation to leave this hospital and be hospitalised in some other hospital”. I said, “Great”. He said, “Take them all out now”. I said, “No, I will not. They are so heavily sedated they will stay here until they can go”. I think a day or two later — Dr Gill and I in that time had a lot of discussion about it — Dr Gill indi­ cated that Dr Bailey’s use of the hospital was very import­ ant to the running of the hospital financially because so many of the patients at Chelmsford were Dr Bailey’s and Dr Herron’s — the majority of them ... [In the end] he could not find another hospital that would accept him using their facilities and the sedation, and he came back. By this time it was clear to Matron Smith that she was unable to run the hospital in a way which provided adequate care for the patients, so she resigned. Although Bailey’s reputation among his psychiatric col­ leagues was at a low ebb, his reputation within the medical profession at large was still high. One patient (who cannot be named) told the Chelmsford Royal Commission that she returned to her general practitioner after Deep Sleep and related her experiences to him. She described the treatment and the terrible conditions at the hospital. She explained that the patients who received Deep Sleep were nursed naked in mixed wards. She described the constant smell of urine. She described Dr Bailey’s inappropriate responses to her com­ plaints, and how the hospital seemed so protective of him, then she begged her local doctor not to recommend Chelmsford to any other patient. No notice was taken of her comments and within weeks the same doctor referred another patient to Chelmsford. This one died.

CHAPTER 9

WHISTLE BLOWERS

It seems impossible for anybody to cause as much hurt, con­ sternation, disappointment and annoyance as Harry Bailey did, and for there to be no ramifications. Yet because Bailey’s patients were all supposed to be emotionally distressed, they had little chance, even if they had tried, to bring Bailey’s excesses and unethical conduct to the public notice. It was not uncommon during this period for doctors to neglect to tell patients or families a great deal about the nature of any treatment that was being provided. The idea that infor­ mation about the technical nature of a treatment, as well as its possible dangers and side effects, should be withheld, and that patients and their families should not be informed about the various alternatives to the treatment selected by the doctor, was often seen by doctors as the best method of preventing confusion. The decision making was therefore in the hands of the technical experts who all, of course, had the best interests of the patients at heart. While this paternalistic attitude received considerable adverse publicity during the 1970s and 1980s, the good faith upon which it was based was never questioned. It had long been a matter of medical dogma that patients were not sufficiently educated to understand the tech­ nical nature of any treatment, and consequently any attempt to explain was likely only to confuse and frighten them. Experience has also shown that in most cases the patients were content to leave medical decision making in the hands of the experts. The likelihood of problems, legal or otherwise, arising when a patient is not aware of the nature of the treatment, only really appears when a person’s treatment does not proceed as planned. This happens when there is a bad result or when the patient is placed in a situation which is unexpected or fright­ ening or unusually expensive. The practice of psychiatry, and the nature of the problems that are being treated, make the 98

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line between any information withheld about the treatment, and unreasonable fear of the treatment created by giving the patient such information, very difficult to draw. The skill needed to draw this line combines an accurate knowledge of the illness being suffered by the patient; an understanding of the patient’s emotional state; the ability of the individual patient to understand and rationally respond to any infor­ mation; and care and concern for those members of the patient’s family, who are often needed to make decisions on his or her behalf. Bailey treated this aspect of medical practice with the same cavalier attitude as he treated bureaucratic and legal requirements. He seemed either to be unaware of or unconcerned by the consequences that a lack of warning about his treatment created. The confusion that Bailey caused his patients and their families came both from his words and his actions. He used a number of ‘standard’ phrases to explain the nature of his work. Coma he described as ‘a good sleep’ or a ‘rest’. Deep Sleep was ‘a good rest’ because it ‘turned the brain off and ‘gave it time to return to normal’. Therapy was a ‘quick cure at his private hospital’ and ‘worked wonders’ because ‘[the patient] needed to get away from the stress of home and work. Brain surgery was ‘a restructuring of the thought pathways’ and the brain was so resilient that ‘you can tread all over it with a pair of hobnail boots’. He described his brain surgery as being ‘no worse than having a tooth out’ and that ‘some patients are back in the snow fields after a week’. He con­ stantly sold his therapies; for example, one patient recalls, ‘he told me that because he was an expert in electronics and the brain was like an electrical circuit, he had an advantage over other psychiatrists’. Comments such as these are to be con­ trasted with the position he took when he was forced to respond to any official enquiry. When Bailey was asked to make a statement to his legal advisers about Deep Sleep at Chelmsford, prior to the 1982 inquest into the death of his patient Miriam Podio, his description of the treatment bore no resemblance to the ‘good rest’ that his patients were told to expect. A different story was told: The patient is put to bed in a special ward where intensive

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care facilities exist. Oxygen, suction and respiratory assis­ tance are available, and specially trained nurses are available continuously. In her report to the Health Commission, a Department of Health inspector had written of her conversation with Bailey: He referred to the considerable skill required for the type of treatment he used, and suggested that a nurse thus entrusted with the lives of patients under what constituted an intensive care situation, might be expected to exercise particular care .. . When his ‘soft sell’ approach failed to work, Bailey was often fully prepared to impose his wishes on the patients. He told a patient who was referred to him by a GP, and who was suffering from exhaustion, that, unless she was prepared to subject herself to Deep Sleep at Chelmsford, he would not give her the medical certificate she needed to be declared fit to continue her job. She complied. He was capable of inventing the most fantastic stories: All I know is that he told me that I had a liver condition that affected the brain cells and he told me that out of 14 women only two of us that he had treated had survived; I was one and there was another lady, and the other 12 had become vegetables and were put in Callan Park. He also failed to appreciate the effect of what he said on his patients. He told one confused young man, who was having difficulties adjusting to an overly strict father, ‘There are two types of people, Martians and others. You and I are Martians. Your parents definitely are not Martians.’ He explained that Martians were ‘some superior race’ and that ‘they had knowledge that other people did not have. They knew what it was all about. They knew the meaning of life. They were the ones who would virtually inherit the earth.’ Sometime after this the patient developed an unnatural interest in the occult. This patient took his own life by taking an overdose of tablets, which had been prescribed by Bailey. Bailey was prepared to lie to his patients in order to impose his will on them. One patient, a 17-year-old whom he had

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never met, was admitted to the hospital, apparently on the instructions of his mother, because he wouldn’t go to work. His mother had spoken to Bailey and the diagnosis had been made over the telephone. The records show that upon his admission he was told that he would be lightly sedated, but a further note written by one of the staff and inserted after this entry states in parenthesis ‘this is untrue!’ Bailey regularly promised patients who objected in advance to receiving ECT that they would not be subjected to it, but, once they were sedated, everybody received the same treat­ ment. Many patients did not discover that they had been deceived by the very person in whom they had absolute trust, until their hospital records were produced at the Chelmsford Royal Commission, often 20 years after their treatment. Bailey’s imposition of his will on his patients manifested itself in a variety of ways. At times he projected great friend­ ship and concern, while at others he could be aggressive and apparently unaware of his patients’ dependence on him. He told Leo Ortado, a patient in his early twenties, that there were three things necessary for a happy life: ‘. . . to eat in style, to drive in style, and to fuck in style’. This display of informality and apparent friendship had followed a period of tension between them. A confused Ortado had told Bailey, ‘Sometimes you treat me good, sometimes you treat me like shit,’ to which Bailey responded, ‘Well you can go and get fucked!’ and with this he stormed out of his office leaving Ortado a more confused and emotionally distraught patient than before. Ortado’s mother, terrified that her son might not be able to receive what she believed was the best treatment, begged Bailey not to desert them. Magnanimously he agreed. As is common in all hospitals, Chelmsford attempted to obtain each patient’s consent to the treatment. This was done by asking patients to sign an admission form. At no time did either Bailey or the hospital staff make any attempt to explain what was going to happen, and, contrary to the practice at every other hospital in Australia, treatment was begun irres­ pective of the existence of the patient’s signature on the con­ sent form. While the failure to obtain a patient’s consent, or provide any true indication of what could be expected during and after the treatment, may have carried with it serious legal ramifications, the personal consequences were far more distressing.

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The nature of the treatment meant that some of the patients were not unconscious all the time. This meant they often witnessed other’s reactions to the drug regime. They saw their fellows ‘moaning and groaning’. As one recalled: It was very traumatic bringing me around. I remember thinking when I started to come around the second time — the first time was quite peaceful, but the second time it was like being in the Hobs of Hell. I could hear people all around me moaning and groaning and crying, and Paul must have been in the next bed and he kept saying to me, “Please help for God’s sake. Please help me. Please untie me. I want my Mother. Please get my Mother for me.” They saw members of the opposite sex lying naked for long periods in their own urine and faeces: They told me to do it in the bed, that they would clean it up. They said everybody did it in the bed, and then I said I couldn’t do it in the bed, and then they got me out of bed and I couldn’t stand up and they put me on a commode. They saw others, and have recollections of themselves, being shackled to the bed by their arms. They recall the discomfort of being fed through a tube which had been inserted in their nose, and many still abhor the taste of Sustagen, the staple diet, and orange juice, which was often used as a supplement. They recall the pain of pneumonia, which was a common side effect, and some have described vividly the terror of receiving ECT when only partly uncon­ scious. ‘I could not pass urine and my stomach was sore and my chest was sore and I was just — I was terrified.’ One thirteen-year-old being treated by Dr Herron for anorexia was left to lie in the darkened sedation ward, scream­ ing in terror. Herron, as the only other long-term exponent of Deep Sleep, described the treatment of this child as ‘appropri­ ate’. Periodically, patients would come out of their comas and in their confusion they would try to escape. People who lived near the hospital not infrequently saw naked patients with tubes in their noses running down the streets. One such patient was pop star Stevie Wright, lead singer of the

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successful 1960s rock band, ‘The Easy Beats’. He had been admitted to Chelmsford by Dr Bailey after Bailey had assured Wright’s manager that the treatment would cure the singer’s heroin addiction. Wright did not sign his admission form. It was signed by a nurse from the hospital. The nurse has subsequently sworn that Wright’s estranged wife had given permission by phone, but Wright has said, ‘She would never have given her permis­ sion over the phone or any other way.’ As with many addicts the sedation caused pneumonia to develop and the drugs were stopped. Slowly Wright regained consciousness and be decided to ‘escape’. He recalled the strange and disturbing feeling associated with lightening out (coming out of the coma): Then [there were] some really horrific dreams that related to Chelmsford . . . and I sensed that there was something evil about the place. I never knew anything about Harry Bailey at that time. I knew nothing about the treatment. I just had to pay the money and I was supposed to be away within 10 days and everything would be groovy. I threw it [the window] up like Papillon and kicked the flyscreen out and jumped out and landed in a rose bush. Because I was sort of sedated it didn’t really hurt that much. I found myself on Pennant Hills Road trying to hitch hike and realised how ridiculous I was after a while because all I was doing was pulling my jumper down over my credentials and trying to get home. Only one car stopped and the woman asked him where he wanted to go. ‘Jump in and I’ll take you home,’ she told him. She was the night sister from Chelmsford Hospital and she drove him around the corner and put him back to bed. On his return Bailey was there and said, ‘You’re a bit of a fuckwit for running away, aren’t you?’ One of the most disturbing aspects of the treatment occurred as the next dose was due, or during the period when the patient was lightening out. At this time patients often suffered the trauma of horrifying hallucinations: They had bay windows there and I think they had Venetian blinds, but I will not swear to that. The windows [sic] were

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always drawn and the rats used to crawl up the windows and across the ceiling, and I used to be so scared I used to think, “Dear God, if one fell on me I cannot shake it off because I cannot move”, and one did fall on me and crawled up my body, and I didn’t have any clothes on, and it started biting me on my neck and I don’t know if it did in reality, but I just screamed and screamed and screamed at him gnawing at my skin. Bailey seemed to be oblivious to the despair that these hallucinations caused. They are a known side effect of the drug regime that Bailey was using, and in a speech he gave to Chelmsford nurses in 1977 he described them in detail. Their impact was even greater because, in some cases, those who were admitted to Chelmsford were already suffering from scrambled thought processes. The preceding stories have been repeated by many patients, countless times. Such was their confusion that, until they discovered that many others similarly had suffered while undergoing the treatment, they believed that they were alone, and that the hallucinations and physical traumas were a prod' uct of their own illness. One patient when asked why he did not complain replied, ‘I had no reason to because I had no comparison with anybody else. I had never struck anybody else who had had a similar sort of thing.’ The class of patients that Bailey treated, the emotionally and mentally disturbed, do not as a rule instigate litigation or inquiries, but it was inevitable that amongst them there should be at least a few who would query what had happened. Those who asked Bailey about their treatment encountered obfusca­ tion and misrepresentation. Those who asked medical practi­ tioners frequently received sighs of disbelief, which only had the effect of reinforcing any diagnosis of mental instability. Those who were suffering from delusions accepted what they thought they recollected as just another manifestation of their unstable mental condition. The social stigma of mental illness being what it was, the majority of patients felt they could not talk about their experiences for fear that people would think they were insane. And this was felt even by people who had entered Chelmsford to overcome addiction to cigarettes,

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anorexia, or mild depression. Many were so ashamed of their recollections that they told not even close family, and chose to live with their nightmares. Although not one patient has ever given evidence at any hearing to show that any medical improvement could be attributed to Deep Sleep Therapy, nonetheless the patients continued to return to Bailey for further treatment. By the force of his own personality and his reputation, Bailey was able to maintain his practice. Between November 1965 and 1978, 1127 patients went through the traumas of Deep Sleep. As no records are avail­ able prior to November 1965, the precise numbers are not known. Bailey’s patients came from all walks of life and included many theatrical personalities. Amongst them were Toni Lamond and Bobby Limb. For some reason Limb’s treat­ ment differed from all others. He received less barbiturate and received better care. Limb was obviously impressed with Bailey and in 1970 asked him to participate in the making of a television documentary designed to publicise the evils of teen­ age drug addiction. Bailey willingly agreed and in an ‘inter­ view’ described the inevitable progression from minor drug experimentation to major drug addiction. The ultimate irony of the situation was that at this time Bailey claimed to be the largest prescriber of tranquillisers in the Southern Hemi­ sphere. The effect of his readiness to prescribe these drugs was to make many of his patients totally drug dependent. At various times, and in various tribunals, the doctors involved with Deep Sleep Therapy have claimed that the whole Bailey episode has been blown out of proportion. They point to the continuing association with his patients as proof. But a number of patients explain it this way: He was so confident. . . He made me feel that if he couldn’t help me then nobody could ... He continually told me about new developments in psychiatry that he was discov­ ering and that I would be better if I just relied on him ... I was convinced that he was my only salvation. I had nowhere else to go . . . When I felt better I was sure it was because he was so clever and when I felt worse I was sure that he could help me ... I just never thought of going to any other doctor.

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To a large extent these explanations mirrored the response of others. Jan Allan has described him as: larger than life. In his own behaviour he was free and easy, but he moralised about where society was heading . . . You don’t meet men like Harry Bailey very often. He added a lot of colour to my life and his friends were very interesting people ... He had this thing that attracted women. They all threw themselves at him. He was very charming and intel­ ligent. One of the things I liked about him most was that he was always teaching you something. He liked to share his knowledge. Jan Allan was 24 years old when she started working for Bailey in October 1968; Bailey was 47. Marcia Fawdry, whose role as night nurse and matron brought her into contact with Bailey more than most people, thought of him in this way: Bailey, he really basically is a bloody nice guy. As you say, somewhere along the line he gets everything out of perspec­ tive and goes off the rails a bit. When you ask him, why are you doing this? why are you doing that? he comes up with a very logical rationale which makes sense and I really don’t think he’s saying it to confuse you. I really think he believes it. I still believe, even in retrospect, that he honestly did believe in the treatment. He was convinced that it was effective. He’s just so convinced that it is right. He is obviously a radical sort of person. Hell no, he certainly wasn’t conser­ vative. He was the sort of person whose presence was felt when he was in the company of people. I think he deliber­ ately tried to be outrageous and yes, I would say that that’s an accurate assessment of him. He’s fairly abrasive and if he doesn’t like someone or what they are saying, he will violently disagree with them as quick as look at them . . . but he also has a lot of arrogance. Men don’t like him but women love him. He certainly has a charisma about him. I don’t know what it is. Clever, intel­ ligent, witty, good to talk to, a true blue person I guess. That’s how I saw him. I really liked him because he

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appeared to be genuine, yes, and you could talk to him about anything and he wouldn’t ridicule you. He might have some people, but he certainly didn’t with me. I can only speak as I found him. She was anxious to draw a distinction between the personal image and his professional performance. This she found ‘unre­ liable] and . . . frustrating] ... he didn’t give us enough sup­ port in relation to his patients in the hospital. I wanted to make a distinction there in relation to how I felt about him the person, and how I felt about him on a professional basis. Throughout his whole life Bailey was able to blur the dis­ tinction between his personal and professional persona, and, apart from his psychiatric colleagues, developed a reputation based on the former, which completely ignored the latter. Fawdry’s professional relationship with Bailey was satisfac­ tory because: I just used to say, what have I got to do? I would have the books ready for him and the patients lined up outside waiting for him. I used to do everything he wanted and, usher them in and usher them out, put the girls to bed and see the next one in, a cup of coffee everytime he wanted one, and that sort of thing. It was consistent with everything that had happened in the past that Bailey needed to be in control, and his relationship with others depended on their acceptance of his need. The first formal complaint directed towards the Chelmsford regime had been aimed at Herron and his breach of Public Service Board working requirements in 1969, but had had no effect on the treatment that was being provided, and, although it led to Herron being reprimanded, nothing changed. And it is rather paradoxical that the first real attack on the ‘team’ should be again directed at Herron and not at Bailey. Barry Hart, an aspiring actor, had endeavoured to improve his chances by undergoing facial surgery. He thought that the removal of ‘fatty’ tissue from under his eyes would enhance his looks, ‘but it made me look like Marty Feldman’. This caused him considerable distress. He contacted a number of doctors who did nothing other than add to his confusion by giving conflicting advice about potential rectification of the

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problem. Hart saw his acting career evaporating and, depressed, was recommended to Herron in 1972 by his family physician. Nearly six months after a series of unsatisfactory consultations, Hart telephoned Herron for some advice. Herron, following the now well-established Bailey tradition, without further consultation, told Hart to go directly to Chelmsford were ‘he would get rid of the depression once and for all’. Hart spent the next few days organising some business affairs that he thought may have to have been dealt with while he was in hospital. He arrived at Chelmsford on 28 February, 1973. He was presented with the standard admission form and, after querying its contents, especially its reference to ‘shock treatment’, he declined to sign. He was by this time very anxious and a member of the nursing staff asked him if he would like something to settle him down while he waited for Herron. Hart agreed. Two weeks later he woke up in Hornsby District Hospital suffering from double pneumonia, deep vein thrombosis, and a pulmonary embolism. He spent the next nine months recuperating from his illness and, when he had recovered his physical strength, set about trying to seek rec­ ompense for what he saw as improper treatment. The attempt by Hart to obtain redress is typical of the problems experienced by most people when they seek to chal­ lenge the expertise of professionals. So apparently outlandish was Hart’s claim that, while solicitors were prepared to take his case, it was clear that they thought his story exaggerated, and probably the product of a mentally disturbed mind. It took Hart nearly seven years to bring his case before a court. The case was to reveal Bailey’s influence. It was found that the hospital was prepared to proceed with Deep Sleep treatment without the consent of the patient, and in spite of his specific refusal. Their willingness to do this demonstrated the general attitude that they had developed toward the long-established rule about the need for patient consent. During the preparation of Hart’s case, his solicitors asked the hospital for his medical records. These were sent. In an attempt to hide the fact that Hart had not signed the consent form when he was admitted, the bottom of the admission form had been cut off. It is not known who mutilated this form. Herron believed that Hart’s reaction to the facial surgery was ‘inappropriate’ and therefore demonstrated a psychiatric

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condition. Almost 15 years later, after Hart began an action against the surgeon who had carried out his plastic surgery, he was awarded a substantial sum in an out-of-court settlement. While technically this is not an admission that the operation was negligently performed or that Hart suffered damage as a consequence, it certainly shows that his reaction to it was not delusional. The action against Herron was, in reality, a challenge to Bailey’s methods, yet he was so intransigent that nothing changed. Ten more patients died at the hospital after notice of the pending action, five of whom died after the hospital had sent the mutilated admission form to Hart’s solicitor. By the time the case against Herron reached court, in 1980, Deep Sleep Therapy had ceased, but the case itself provided the greatest insult that could have been paid to Bailey. Herron was Bailey’s junior both in years and public stature. The treat­ ment that was under challenge was Bailey’s. Herron acknowl­ edged Bailey’s role in the treatment, yet Herron’s lawyers decided not to call Bailey as a witness for the defence. By this time Bailey had been thoroughly discredited within the psy­ chiatric profession. After 78 sitting days in the New South Wales Supreme Court, the jury found for Barry Hart against Dr Herron on each of his three claims of assault and battery, false imprisonment, and negligence. They also found for Hart against Chelmsford Hospital on his claim of false imprison­ ment, but rejected his claim of assault and battery against the hospital. The jury awarded him $36,000 compensatory dam­ ages and $24,000 aggravated damages. On 2 November 1973, eight months after Barry Hart had been transferred to Hornsby District Hospital needing inten­ sive medical care, a 59-year-old woman was admitted to Chelmsford. Her hospital notes have disappeared, but Bailey’s book records that she was suffering from depression. Once again he failed to carry out a physical examination on his patient before recommending his special treatment. Had he done so he would never have sent her to Chelmsford. She may have been depressed but she was also suffering from an acute abdominal infection, the symptoms of which were masked by the sedation. Nine days after she entered Chelmsford she was obviously extremely ill and was transferred to Delmar Private Hospital, and then to Manly Hospital, where she died on 22 November, 1973.

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Both Mrs Bailey and Jan Allan have said that Bailey rarely spoke to them about medical matters, although Allan is sure that Bailey was always distressed when a patient died: He was worried about patients dying but if you are so sure, as he was, that your treatment is the only way, you have faith that these deaths wouldn’t keep happening. He had total faith in his treatment, he never talked about stopping it. In retrospect, it is clear that the only person who would ever bring the horror of Chelmsford, or the excesses of Bailey, to the public notice was someone who had not been influ­ enced by his personality. In 1972, a young trainee nurse, Rosa Nicholson, was asked by a nursing employment agency to relieve for a day at Chelmsford. She was bright and inquisitive, and when she was asked to attend to the patients in the sedation ward she was both interested and horrified. Her recent training had alerted her to the dangers of long-term coma, as well as making her aware of the technical equipment needed if the health of the patient was to be protected. She was astounded to see none of these provisions available at Chelmsford. This short stint had a profound effect on Rosa, ‘I talked about it non-stop!’ She telephoned the agency and made herself available for any pos­ ition that might become vacant at Chelmsford. She asked all her lecturers about the treatment but when she mentioned Bailey’s name she received an almost standard reply: ‘Yes, I have heard of Harry Bailey. He is nutty. He is eccentric.’ Two months after she first witnessed Deep Sleep she wrote to the New South Wales Health Commission detailing her experiences, and a short time later she also wrote to the New South Wales Nurses’ Association. The nurses’ association replied telling her that they had no power to act, and the Health Commission did not even bother to reply. Her per­ sonal circumstances prevented her from pursuing her desire to expose Bailey, and, coupled with the negative responses she received after her initial enthusiasm, the incident receded to the back of her mind. During the latter part of 1974, however, she learnt of the death at Chelmsford of her friend, a well-known artist, Arnold St Clair, who had died in May. St Clair was 49 years

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old and was admitted in an attempt to cure his chronic alco­ holism. This incident caused her to feel guilty that she had not made a greater effort to find out more about Chelmsford. She had assumed that her complaint to the Health Commis­ sion would have been acted on, but St Clair’s death starkly showed her that this wasn’t so. She again resolved to seek employment at the hospital. She pestered the agency but was told that Chelmsford rarely required agency nurses. Her lack of success in getting a job at Chelmsford through the agency resulted in her telephoning the hospital at regular intervals enquiring about job vacancies. Throughout 1976 she sought work and spoke regularly to the matron, Julie Smith. Persis­ tence finally was rewarded and she was employed on 28 Feb­ ruary, 1977. Nine people had died at the hospital between the time she was first employed in 1972 and the time she returned. Friends had told Rosa that the only way she could convince anybody to listen to her was to provide ‘evidence’. This advice was entirely consistent with her experience as a nurse, where the hierarchic structure of the medical profession made it almost impossible for someone like herself to challenge the authority of a doctor. From the moment she started work at Chelmsford she began to collect ‘evidence’. I had to go more or less blind, because I really had not had any training in things like investigation, but I was a very inquisitive person. So the only thing I could do was go to the register. I wrote down daily reports at the end of every shift, exactly who said what and what happened. Anything that happened. I also decided to go to the patient register which was under the shelves in the entrance, in the reception area, and I used to go through and get names [from the admission register], Rosa’s next decision involved what she was going to do with the information she collected. She had met Ron Segal, then the head of a lobby group called the Citizens’ Committee on Human Rights (CCHR). This rather high-sounding title masked the fact that this organisation was sponsored by the Church of Scientology. The agenda of the CCHR included

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the discrediting of psychiatry, with a special emphasis on lob­ bying governments to secure the banning of ECT. Rosa’s contact with a ‘branch’ of the Church of Scientology was both a boon and a hindrance to her ultimate goal of exposing the abuses of Bailey and Chelmsford. The CCHR was not inhibited by any preconceived notion of medical infal­ libility and it brought with it considerable skill in ensuring that ‘favourable’ information received media exposure. As a supporter of her cause it was a doubtful ally. The Church had been banned in Victoria following an investigation into its practices, especially those involving the vocational guidance testing of children, so the revelation of abuses, even if accu­ rate, made by an organisation sponsored directly by the Church, was bound to be treated with scepticism by officialdom. Its ‘interest’ in the whole area of psychiatry guar­ anteed a lack of cooperation from the larger body of the psychiatric profession. It was out of the question that they would be associated with an organisation hell-bent on their own destruction. At a later stage, Dr John Sydney Smith wrote to the president of the Royal College of Psychiatry in London, Sir Martin Roth, seeking advice about the most appropriate procedure to remove Bailey. Smith received a reply which included a warning that any investigation into the practice of psychiatry by psychiatrists should ‘proceed with caution’ because any adverse conclusion would leave the pro­ fession vulnerable to further criticism from the ‘scientologists’. During his case against Dr Herron, Hart found that his limited association with the CCHR was a decided disadvan­ tage. Counsel for Dr Herron made much of this association and attempted to imply this fact alone made his claim invalid. Segal advised Rosa that her notes alone were not sufficient to mount any attack on Chelmsford. Rosa’s response can be best described as a combination of James Bond and Monty Python. She decided to photograph as many documents as she could. The only place she had any privacy was the staff toilet. I took a camera with a microfilm in it. [It] did not have a flash. I understood that I had to have the camera a certain distance away from the material I was photocopying, not photocopying, photographing at that stage. So I had a piece of tape that was that length tied to the side of the camera and I would place it in position so that the end of the string

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was touching. It actually meant I had to stand on the toilet seat with the material on the floor and photograph that, because otherwise if I was standing up I was too far away, and I could not direct the lens to the material properly. I could not see. I had to flush the flusher, because the click of the camera made a noise which made me think someone standing outside might hear it, the clicking, and wonder what I was doing in there. Rosa gave the undeveloped film to Segal and was disap­ pointed to find that her exploits as a photographer were less than successful. She was still anxious to take as many shots as possible: What I wanted to do was to just get photographs of what­ ever was happening. In particular I would have liked to have got some good photographs of what was happening in the sedation ward. So what I did, we used to use fourhourly administration of Sustagen and alternatively orange juice. We had Sustagen boxes which at some stage or other would get emptied. So I took an empty Sustagen box and made a hole in it which matched up with the lettering on the back and put a camera in there with another hole at the back so I could stick my finger in the back of it and click it when Dr Bailey was there, or someone was being attended to, and get a photograph, but it didn’t actually work out, because I had it all lined up the wrong way, and the box moved. I think some of the staff must have thought I had a bladder problem, I kept on going to the toilet so many times. I had a problem. I had to find out what to do and I decided that the only answer was to actually photocopy them. I looked at the idea of hiring a photocopier and things like that, but the result was I actually took the files out of the filing cabinet, put them underneath [a] pillow, and then a few hours later I would go back and shift [them] down to the front desk and hide [them] in another hiding place, and a few hours later I would go down and get those files and then put them in my car, and I would take them at the end of my shift to the nearest photocopier. There were quite a lot of photocopy machines around that I had even­ tually got to know and I used to go to whichever one was

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the closest and photocopy them and then return them to the files and keep the photocopies. Rosa copied everything she could find including all docu­ ments in the patients files. Together with the photocopying Rosa made a daily report at the end of each shift. She main­ tained this routine for 14 months. Each report was made in duplicate: one copy she gave to Segal at the CCHR and the other she kept for herself. Initially, Rosa’s reports did not excite much interest inside the administration of CCHR but three deaths galvanised them into action. Rosa was present at the hospital during the many treatments of Sharon Hamilton; she was present during the hospitalisation of one of Gill’s patients, John Adams in 1977; and she nursed the last of Bailey’s patients to die while having Deep Sleep, Miriam Podio. She provided the CCHR with detailed information about these deaths. Podio died on 12 August 1977, and Adams died on 30 September 1977. John Adams and his family had been long-time friends of Gill. John was a drug addict and Gill had offered to try to cure him using Bailey’s exclusive technique. Adams had been admitted to Chelmsford on five previous occasions in an attempt to cure his addiction, twice for Deep Sleep Therapy, but without success. Adams’ younger brother was represent­ ing South Sydney in the 1977 under-23 rugby league grand final and John was anxious to attend with his family, but wanted to ‘dry out’ before the match. Following Bailey’s lead Gill seemed to think that Deep Sleep was the equivalent of a good rest and suggested that three days’ sedation would be sufficient. On both the previous occasions that Adams had received the treatment he had reacted badly to it. He had suffered from chest complaints and, because of his continued addiction, he was in a physically debilitated state and thus was certainly not a suitable candidate for any form of sedation therapy. This time, too, Adams reacted badly. As Adams’ con­ dition deteriorated Gill reacted in the same cavalier manner shown by Bailey to his patients. He failed to supervise his patient and within two days Adams had to be transferred to Hornsby District Hospital, where he died two days later. The consequence was but another example of ignorance and con­ fidence proving to be a fatal combination. Rosa’s description of the death of Podio, and Bailey’s

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response to her urgent plight, shows the depths to which he had sunk and the effect it had had on otherwise caring staff: She was very ill from the very first time she went into sedation. She was being given massive quanities of the hypnotics and barbituates, the same as anybody twice her size. She was ill the whole time she was under sedation. I understood from the registered senior staff that there had been many attempts to get Dr Bailey to come and look at this patient and he had not done so. At least once or twice I was told by one of the registered staff that he had been rude and had abused her for asking him to come. I remember that she didn’t get what I myself and other staff had talked about as the sufficient care from Dr Bailey. She was very ill and she looked very cyanosed one minute and yellow — her skin yellowed and the whites of her eyes looked yellowy at some stages. She seemed to be quite ill and there were reports constantly about this, and for some reason Dr Bailey just did not come. In April 1978 Rosa heard rumours around the hospital that in the event of any investigation into the doctors or the hos­ pital all the records of the treatment would be destroyed. She reacted immediately. She took as many daily report books as she could carry and resigned. She was frightened about her illegal act and kept the books under the seat of her car for almost two years. One day while at the CCHR office she heard that they might be helpful in Hart’s case. With some relief she handed them over to the new chairperson of the CCHR, Jan Eastgate. By mid-1978 the CCHR had decided that Chelmsford and Bailey were a chink in establishment psychiatry’s armour, and a campaign began. In July 1978 they wrote to the Attorney General for New South Wales, Mr Frank Walker, and after pointing out the financial relationship between Bailey and Sharon Hamilton they questioned the outcome of her inquest. They demonstrated outside Parliament House and, as a conse­ quence of Rosa’s undercover work, Segal sent documents relating to Bailey’s treatment of Hamilton at Chelmsford to Walker. Although Bailey was not aware of it, there were also stirrings within the Health Department about the need for

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some form of official investigation into the hospital. He would have known, however, about the reports that were beginning to appear in the daily press: A deep coma therapy for drug addicts at a Sydney northern suburbs hospital is being inves­ tigated by the Attorney General’s Department’. In October an article appeared in the Sunday newspaper which contained a list of allegations given to them by CCHR. It was claimed that patients died as a result of Deep Sleep; that they were given ECT without consent; that patients suffered serious damage as a consequence of the treatment; and that pre-signed drug sheets were left for nurses to fill in. Since the size of the hospital had been increased to 40 beds the management had taken active steps to encourage other psychiatrists to send their patients to the non-sedation section of the hospital. Apart from the horrendous nature of the Deep Sleep ward the general service offered was of a high standard. The adverse publicity that the hospital was receiving caused some of the doctors to become restless about their use of the hospital. About the same time, staff at nearby Hornsby District Hospital, the nearest teaching hospital to Chelmsford, were beginning to mutter amongst themselves about the number of patients who were being transferred from Chelmsford to Hornsby. Matron Fawdry recalls one instance when she telephoned Hornsby to enquire about the health of a patient who had been transferred there: I can remember on one occasion, and it was whilst I was the director of nursing there, the RN that I spoke to, and I can’t remember who the client was, but the RN that I spoke to was really hostile and said she was sick of getting Chelmsford’s mistakes, and she said, “What the hell are you doing to them down there?” something to that effect and I was a bit taken aback by that attitude . . . One of the doctors who used Chelmsford to hospitalise his patients was psychiatrist Dr Brian Boettcher. Boettcher was aware that Drs Bailey and Herron were using a different form of treatment at the hospital and that it was carried out in a special ward. He had looked into the ward and some of his patients had expressed anxiety about what was going on in it,

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so he asked if the door could be kept closed. At one stage he asked Herron about the nature of the treatment and received much the same explanation that both Herron and Bailey habitually gave to the patients. Dr Boettcher was told: The treatment was along the rest/cure lines and the rest/ cure has been a treatment in psychiatry and still is. He said it is an extension of the rest/cure. It gives the relatives and the patients a break. I came away thinking that maybe there is something in it. It was also a withdrawal from drugs. You have to sedate people . . . This explanation he found ‘very plausible’ and thought little more about it. However, he was reminded about the treatment by some Hornsby Hospital nurses at a social function for the staff of that hospital: I started to chat with them and when they found out I was at Chelmsford, they sort of reeled back in horror. At first I thought, Oh, they don’t like private hospitals, and I was nearly going to ignore it but then I decided to ask them why they reacted like that. They were very reluctant to tell me at first. But they did tell me that there had been criti­ cally ill patients. They were quite adamant actually, and when they started to tell me, they really got wound up about it. I was a bit stunned by their reaction then, that there had been critically ill patients coming to Hornsby Hospital from Chelmsford Hospital. They were really angry. I think they were something like second and third year nurses who had seen these things happening. There were only two of them that I remember, and I never . . . there was just social talk and when they said all of that, I rather had my doubts. I thought they were exaggerating, and I did not understand why they were angry, so I moved on in the party . . . . . . they said there were critically ill patients coming in, and, that’s right, the other thing they said was that there were bed sores on the patients. That really upset me. You can expect a few bed sores, but not many, although nurses probably would not agree with that statement. No, I think

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the critically ill aspect and the patient with bed sores aspect were the main things that they mentioned. They did not mention anybody coming in dead though, although they said they were nearly dead. [It was not common for second or third year nurses to speak up] that is why they were shy at first, but when they realised I genuinely did not know what they were talking about and that I was interested in what they were saying, then they started to tell me, and then they got more and more angry the more they started to tell me . . . I think they deserve a medal for speaking to me like they did. Boettcher was most disturbed by what he had heard and the following morning he went into the matron’s office and demanded to be shown the death certificate book. Boettcher was stunned to discover that there had been at least one death per year since the treatment began. Because psychiatric patients are usually physically healthy, it is almost unknown for them to die as a result of their treatment. This left Boettcher in a rather confused state and he left the matron’s office, I just knew I had to do something, but I didn’t know what to do. I started to walk down the corridor and then I saw Dr Huppert in the corridor, so I barged up to him and said, “Do you know there has been one death a year from this sleep treatment?” And he said, “No.” And something like, “What are we going to do about it?” I said, “I don’t know.” I think he said, “Well, let’s have a meeting,” and I said, “All right, what about tomorrow night or the night after?” I can’t remember now which we decided on, but he said, “Okay.” Then he said that he would contact his contempo­ raries, Otto Reichard and — I can’t remember . .. Eleanor Dawson, I think he contacted. I contacted the ones around my age, Blows, Berecry, and I think I rang Dr Herron, rather nervously, and he agreed to come which almost sur­ prised me. Boettcher was nervous about calling Herron because

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Herron had been his superior at North Ryde Psychiatric Hos­ pital and, as such, Boettcher held him in high regard. There was some discussion about inviting Bailey, but in the end they decided not to, because, as they knew he had been in hospital sometime earlier, they believed that he had had a heart attack. (This stay in hospital had actually been his time under sed­ ation at Chelmsford under the name of Harry Lee, which the nurses knew about, but the doctors didn’t.) The meeting was attended by Doctors Richard Huppert, Otto Reichard, Eleanor Dawson, Lawrence Blows, Herron, Gill and Boettcher. Except for Dr Gill, all those who attended were psychiatrists who sent their patients to Chelmsford. It was held on 20 November 1978, at the home of Dr Huppert. Herron refused to discuss the deaths although he did not deny that they had occurred. All the doctors expressed concern about the bad publicity the hospital was getting because of Bailey’s Deep Sleep Therapy and about the comments about his unethical behaviour. The meeting ended in a stalemate, with Herron standing his ground and refusing to stop using the treatment, and the others stating simply that if the treat­ ment was not stopped they would take their patients from the hospital. The next day Boettcher took his only patient away and during the next week the others followed suit. On 21 November, when news of the meeting reached the hospital owners it was the last straw. They were already con­ cerned about the adverse publicity the hospital and Bailey had received. Dr Gill brought the news of the meeting to the directors of the hospital while they themselves were having a board meeting of the company, Dainford Limited, which held a controlling interest in Chelmsford. A directive was given to Gill that he convey the board’s decision to Bailey that Deep Sleep Therapy be terminated and that he himself leave the hospital. Gill delayed for some weeks but finally told Bailey that his patients were no longer welcome at the hospital. Bailey made no attempt to justify his treatment regime in order to save his position. There is no evidence to show he tried to argue with the directive. Had Gill not procrastinated, the treatment would have been terminated immediately, and Coralie Walker, one of Dr Gardiner’s patients, and the last to receive Deep Sleep

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Therapy, would not have suffered the horrendous injuries she did. The hospital’s decision effectively ended any hope Bailey may have had of maintaining his credibility within the field of psychiatry. His twin dreams of Deep Sleep and psychosurgery had been effectively outlawed, and within the profession, so had he.

CHAPTER 10

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Bailey and Herron constantly emphasised that Deep Sleep Therapy at Chelmsford was safe because it was administered by properly trained staff. Herron has even suggested that the treatment was not offered at North Ryde Psychiatric Hospital, a major Sydney hospital, because the staff were not trained for coma therapy. There was no medical school nor nurses’ train­ ing course which offered instruction in this therapy. Bailey continually asserted that all the nurses at Chelmsford received such detailed instruction about Deep Sleep that, while the treatment required them to make medical judgements usually reserved for trained medical practitioners, their special exper­ tise overcame any lack of formal training. In her anxiety to obtain as much information about Chelmsford as possible Rosa Nicholson suggested that Bailey give a lecture to the staff about it. She pointed out that the hospital needed three shifts of nurses to maintain the Deep Sleep ward. She asked Bailey if she could tape it so that those who were unable to attend, because they worked a different shift, would hear it. While Rosa was anxious to gather as much as she could about Bailey’s theories and practice, Chelmsford was experi­ encing another problem. When Bailey left St Anne’s Private Hospital in 1963 he had been fortunate enough to have con­ vinced Sister Betty Shea that his treatment would give other­ wise helpless people a chance for a normal life. So she had left St Anne’s with him and taken up a position at Chelmsford. She has been described by Herron as ‘one of the culture carriers’ of Deep Sleep. Yet by mid-1976 Shea was having strong doubts about the nature of the treatment and its effec­ tiveness, and seemed to be guilt ridden by its drastic conse­ quences. She had been promised by Bailey that she would be the matron at Mandala when it opened but, as the years had gone by, it had become apparent that Mandala was just a 121

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dream. In October 1976 she asked Chelmsford’s Matron Julie Smith if she could be moved from the sedation ward. Smith agreed, and recalls: ... when she talked to me about wanting to get out of sedation, a lot of the things she said were about her feelings of guilt about what had happened in the time she had been involved in sedation. She felt she was caught in it now and didn’t know how to get out. Sister Fawdry, who had worked with Shea for many years, was also alerted to the fact that Shea not only wanted to be moved from the sedation ward, but to move away from Chelmsford entirely: I think she was really fed up with Chelmsford. She used to hate coming to work. She said, “I hate this place; I’m sick of this place”, but she had been there so long she didn’t think she had much of a chance of getting anything any­ where else ...” Bailey’s reaction to Shea’s departure from the sedation ward bordered on the hysterical. He had a shouting match with Smith because she acceded to Shea’s request and then he confronted Shea. She went back into the sedation ward. This caused her great emotional pain and she spoke to Smith about it, who remembers: I had understood what Betty was going through because we talked about those sort of things, and she would say that she did go back and work in sedation because when Bailey found out that I had actually moved her out of sedation, well, all hell broke loose. Poor Betty was seen by Bailey and I don’t know what he said to her, but she went back in there. [She] went back to work in that area and in July [1977] she suicided. When the hospital had expanded from 15 to 40 beds in 1972 the owners let other psychiatrists know that the hospital was available. It was therefore natural that most of the nursing staff should be ‘psychiatrically’ trained rather than ‘generally’ trained. At this time psychiatric nursing training took only

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two years, whereas a general nursing certificate required three years to complete. The former carried with it a heavier empha­ sis on the custodial nature of psychiatric care, and the latter concentrated more on the medical and surgical aspects of nursing. Although Deep Sleep purported to be a psychiatric treatment it was, in reality, medical in nature. If indeed it could ever be carried out safely, it required extensive nursing skills for this to be accomplished. As a general rule Bailey restricted his communications to the nursing staff to the cryptic notes he wrote in the ‘Bailey Book’, and he spent as little time at the hospital as possible. His visits to the sedation ward were brief. He would walk into the ward, walk quickly past the beds and leave, often without saying a word. It was because of this combination of circumstances that Bailey delivered his ‘lecture’ about Deep Sleep. It might have been an appropriate time to remind the nurses of the risks of oversedation or of the interaction of the various drugs. And it would have been helpful for them to receive some instruction about visual signs of distress or contraindications for contin­ ued sedation. Their feelings of self-worth would have been improved had they heard that the traumas of the day-to-day practice of the treatment were all worthwhile because of the successes they achieved. Instead they heard a rambling lecture. Rosa Nicholson recorded it on her tape recorder. Many pas­ sages and words were unintelligible. We have tried to repro­ duce those parts of the lecture which demonstrate Bailey’s perception of psychiatry, but in a slightly edited form, suggest­ ing words or phrases to help find the sense. Well, once upon a time I used to do a lot of lectures and I regularly used to be asked ... all I’d like you to do is listen to the whole concept of psychiatry as I see it, because it’s a little different now, and particularly to the treatment of depression, as this is the thing that I have been interested in now for about 30 years or so, different ways of treating depression. And of course the thing that hassles everybody is this deep sedation technique. Actually, it was first done ... in the American Civil War, by a doctor then who was quite famous for putting soldiers . . . particularly from the body of the South . . . who were being poorly fed and poorly

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clothed. They had no foodstuffs at times in mid-winter, and they were in terrible shape, these people, they were scared. They were simple farm boys, country boys, some of these boys, and [they turned] up at their first aid stations, paralysed and with acute depression and hysterias, and so on. And this doctor didn’t have any treatment then, he didn’t have the stock or medications, but he had opium. And he started giving these people large doses of opium and making them just sleep . . . and lo and behold they all got better. After the Civil War he went to New York and built up a very big practice, where he still conducted this opium treat­ ment. Of course he addicted a fair number of people in the process, [but] he didn’t realise that. But nevertheless the principle was first established then. Then a fellow in Switzerland, back in the beginning of the century, started treatment. Again, the problem was that he had a very poor range of drugs to do it, and the barbitu­ rates that were available then were pretty savage ones and long acting. It was quite horrific to see. Actually I saw this treatment in Zurich many years ago. But it never took off very much because of the risks, the infection rate, the pneumonias, all the problems, so no-one did it for any length at all. In 1951 I went to work as a psychiatrist at Broughton Hall. At that stage Dr Wreschsler had arrived in this country, it was in 1950 I think, and he brought with him this new treatment called full coma insulin. This was invented by an American doctor who had, accidentally in a way, on quite a wrong basis as often happens in these things, developed a system of putting schizophrenic patients into a state of insulin coma. And this was found to be the first breakthrough, I suppose, in treating schizophrenics. Until then what did you do? You’d “bop them one”, you’d give them electrotherapy. This had just started in the 1930s, about the same time, shortly before this. But the full tale of this insulin treatment was fascinating. I was given the job of developing full coma insulin treat­ ment in the Health Department Hospital. This was quite a horrifying procedure. To see it, you just wouldn’t believe that it was done. We used to have a ward which had 10 beds, 12 beds, and the patients normally slept and lived in

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that ward. But every morning from Monday to Friday, they were given an intravenous injection of soluble insulin. The dose would vary between 30 units to 1000 units [given] intravenously. The idea was you started it low, [with] 20 units, and if 20 units didn’t put the patient in a coma, the next day you went to 40 units, and the next day to 60 and 80 and 100. And after approximately 2, 3, 4, 5, 600 units you’d find the patient would, within 20 minutes or so of getting the injection at 6 a.m., start becoming comatose and down he’d go, dm, dm, dm, dm, down into a deep midbrain coma. [With] no reflexes, stertorous breathing, [they were] in deep insulin coma, which normally one reads about amongst diabetics, but you never see it, if [the diabetic] finally gives himself an overdose of insulin. And this is horrifying, this is a whole ward thing, and there you’ve got 10 of them all . . . ed out. Now, after one hour of deep coma — the point which they have reached has got to be deep coma — you then reversed it. And to reverse it, you took a needle and syringe and 50 per cent solution, one portion of glucose, like toffee. This was specially made up for us in those days by Parke Davis, in little bottles. ... If you put the needle into a vein and pressed the syringe forward, by the time you’d inducted 20 cc here, 10 or 15 or 20 cc, the patient was waking up and saying, “How are you feeling, Doctor? I feel terrific!”, and you’d watch them come out of the coma, ch, ch, ch, out again. And here was the most marvellous demonstration of people going down into deep coma and up again. So the treatment had some merit. But this was not the point. The point was that, from time to time, something would go wrong, and we would get a condition called irre­ versible coma where you put them down into a coma at 6 a.m. and they went through their hour’s deep coma, and then you injected the glucose and nothing happened. Now here was a horrifying situation, because if you [leave] them in this state of deep coma, you’ve got inevitable and ter­ minal brain damage or death. Now we had to [do] give this treatment every day. So we lived in fear of irreversible coma. And if you got an irreversible coma, you might be [faced with a patient in a coma for] two hours, four hours, six hours, 24 hours, 36 hours, or a week, you didn’t know. We

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didn’t even have decent drip sets in those days, we had no corticosteroids, and we used to do all manner of things to get them out: lumbar puncture them, drain all their cerebrospinal fluid out and pump it back again, I used to give them Pentothal anaesthetics, all kinds of things, but nothing was terribly effective in getting them out of coma. But we were lucky, I was lucky, I had a few in and I got all of my irreversible comas out of coma . . . . . . These patients, mind you, were schizophrenic ... If they went into irreversible coma, say, [for] six hours, [and] you got them out again, you woke them up, they were no longer schizophrenic. They had not a sign of the illness. No thought disorder. No disease of the brain . . . They had come back. Now this struck me one day, you know, “What is it about irreversible coma that is doing what the ordinary full coma treatment of one hour every morning is not doing?” Because we’d do 30, 40, 50, 60 days of just an hour a day. At the end of that time, well, maybe they were better — some of them were, some of them weren’t — but we weren’t terribly convinced. But you take a patient who had only, on the first day of treatment, had a reversible let-down for, say, 10 hours, and you finally got him up again absolute . . . And so I set out to see whether I could find a way of making a reversible coma clinic. But I couldn’t get a nurse to work for me, because it was hard enough to get them to work in the full coma clinic, because when the hour was up, you had to go around and sit on the patients and get needles into veins anywhere in the body. . . . Sometimes we’d have three girls sitting on top of a patient, with the doctor on top of them [with] the needle and 50 per cent glucose trying to get it into a vein in his ear or somewhere, or in the jugular, or whatever. We got very good at putting needles in writhing, moving bodies. We’d approach, and go, ch . . . So all attempts to make a reversible coma clinic met a stony opposition with everybody concerned, because, after all, they had the shit scared out of them with ordinary treatment, let alone anything irreversible. But I then started to put people into as close a stage of [irreversible coma] as I could, and of course, the principle still applies. In earlier days when we started here, we put people into a very much deeper . . . sedation than you’re witnessing

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[now]. They’re just asleep, those people. [In the past] we put them twice, three times as deep as that, and we got much better results than we’re getting now. Of course, it was rougher and tougher and, well, you know, the girls used to go grey in a matter of a few weeks. But, nevertheless, the depth of the coma was the critical thing. This is why you’ll hear the [professionals] here like Shea and others always beating the drum about. . . “You must keep them down”. In the early days when we started this, we didn’t have all the nice drugs, because all these nice drugs mainly came after. In the old days [when I began] doing the sedation treat­ ment, which I tried to follow on from deep coma insulin, all they had originally was a drug called Somnothane. This was an injectable ampoule of a mixture of barbiturates, of hyoscine. It was a terrible, mucky, dark brown stuff and it gave everybody abscesses when you injected it. You injected this into the patient every six to eight hours, and they had abscesses all over their legs, reversed them out on the floor, so that everything sort of levelled out, urine, faeces, Somnothane, patient, ... it was a terrible business, but they got better these people. And after that, we used the Somnothane stuff, and any other drug I could get hold of, as the new drugs came on. Neulactil came in very early in the piece. Again, because I had approached and they had given me Largactil. It was shortly after that they invented Neulactil . . . And in those early days, it was, we hit them [the patients] down very savagely and had them very deep [in coma]. But of course, this was, again, we didn’t have quite the experi­ ence that we have today, and we didn’t have the antibiotic cover, that was the problem. We got the infections. We put these people under sedation and, of course, they began to get to all the depots where organisms are thriving, they are going to spread. Those are the sort of things we [experi­ enced] for years — we didn’t have these stylish antibiotics we have today. But, nevertheless, we battled on and in fact the total number of hours of treatment that have been done in this hospital, last time I added it up, it was four-and-threequarter million patient hours. So we should be over the five

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million hours of treatment so far, which is an awful lot of hours for treatment. That’s patient hours. And out of all this, “Well”, I thought, “Well, what comes out of it?” Well, of course, unfortunately, the stationmaster at the railway station never sees where the train goes, although it passes [another] couple of other stations, of course, and you girls are in the same boat. You don’t see that they’re decent a year on, back at work, coming in for follow-up, and so on. .. . But somewhere along the line, we grafted the [ECT] onto the deep sedation business and found that we got very much better results than with either technique alone. So the final technique was to put [patients] into a sort of deep coma [and] hold them down for a certain period of time. Now, we tried all kinds of variations of this: I’ve had them down for 8, 10, 12 weeks, we’ve had them down for 24 hours; and this period that we use here, around 14, 16 days, seems to be a reasonable compromise. If you leave [the timing] too short, you don’t get as good results. The effec­ tiveness of the treatment is a function of the depth of the sedation. If you keep them down deep, and hold them down deep, they will do better, very much better. So you sedate somebody down and so they dive down with the dose you start giving them, (I’ll come to how to do that), and after two, three, four hours, they turn around and they start to come right out. And of course if you let them come right out, you’ve got troubles because their shit ends up all over the bed. The real art is, of course, to watch them turn around, and as they come out, then you bop them again. Now this brought us face-to-face with a monstrous prob­ lem. We had to, for the first time in the history of nursing, rely on the nurse making the judgement [about] whether [a] patient was [to be] given medication. Now, all these nurses, of course, had been thrown into hospitals where they had been taught not to touch. You gave nothing to nobody unless it was written up on the treatment sheet. That was that, no breaking with this basic rule. And here we had: “Look, you have to make the decision as to whether this medication goes in, because you have to be there watching and deciding that the patient has turned around and is on their way out. If you leave it too late, they’ll come right out, and they’ll be fighting. And you’ll be losing.” This brought

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up all sorts of problems, but I found, in actual fact, my predictions were right, I think, because I, we, found that [the nurses] were terribly good. You did either one of two things; you either did without nurses who never have much flexibility . . . The nurses, of course, learnt to do it . . . Sister Shea, I suppose, is not the best example because she’s [been here] longer than [anyone] . . . It’s something that you either get the hang of or you don’t — it depends mainly on the state of — not too much on — previous training. Either you get this or you don’t, I suppose . .. preparation, designed to keep people asleep, because the Seconal, which is very rapid acting and lasts only for about an hour. The idea is, that [it] put the patient to sleep, [while] the Amytal, which is slow acting, long action, kept them asleep. And generally speaking, if you or I took Tuinal, that’s just what would happen, we’d go “Zonk” and pass out, probably for eight hours. [It’s] ... quite effective medication. So we used Tuinal. Now we’ve found out that of all these brand new drugs that were coming through, this Largactil stuff, the Neulactil stuff, Stelazine, Trilafon, and Melleril, all these phenothiazine drugs could be added to the Tuinal and we’d intensify the effect. And here was a terrific breakthrough, because we could get less medication into the patient’s bloodstream [yet] get deeper sedation. And that’s still what we do today. In other words, the Tuinal goes in as a baseline drug, but then, if you ever have a party where you run out of butter, what you do is rush in and get the refrigerator open, get the milk and mix it in with the butter, stir it up like crazy, and you double the amount of butter you’ve got that you want to put on the sandwiches. And that’s pretty much the principle. So, we found that we didn’t need to increase the Tuinal too much, all you have to do is just add a bit more of the synergising drug which we’re — [it] varies, depending on what you’re looking at at the time. Neulactil has — [it] seems to have stuck, all over the years, because it’s been very safe, a good one. In recent years, we’ve been using the buterophenone drugs, particularly Haloperidol, and any of these will do. Because we’ve had numerous cocktails, and they’ve all worked the same way, they take the patient down for less drugs. The principle was to give them the cocktail, take them

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down, watch them reverse, [then] as they are coming up, hit them again with the drug, [and] keep them down. That, plus other problems. ... six months if necessary. So, blad­ der — different thing. You had to take them to overflow. This has always been a problem with overflowing bladders, [we’ve tried to deal with it] in all different ways, bowls in the beds, plastic drain, pumps, all sorts of things, [except] catheterised them. We’ve never liked to catheterise them, for obvious reasons. Catheterisation provides a highway straight into the bladder for everybody’s bugs and germs. And it’s a dicey business. With females, [it’s] not so bad; with males, it is. But we’re now getting to the stage where perhaps it might be more practicable to catheterise them. For the first time, we’ve got antibiotics good enough, and catheters [and] equipment good enough, [so] that it might even pay to put catheters into these males and leave [them] there for two weeks and three weeks [at a time]. That’s something that’s got to be explored now. It was impractica­ ble up till now. So, we’ve always had the overflow bladder situation and the constant problems that are associated with this, excoriation and wet backs and so on. But this means, this is a test, of course, in good nursing, and this is why you are constantly changing those bloody beds. And it’s a credit, of course, to the nurses in this place that over the years I’ve had [to treat few] bed sores. [They] just don’t exist, even apart from ripple beds. Ripple beds came in — I first got the first ripple beds in Australia when I went to England in 1956. I saw the first one there; [it was] very good and [I] brought it back and then designed . . . and got the agency for them, and we’ve been using them ever since. They’ve got defects, but it’s a nice, simple, reliable technique . . . removing the pressure points, ... So bowels and bladder, [that’s] one problem. Food, well that was easy also, ... we tried at one stage at St Vincents. [It is not] easy to put a gastric tube in, and [it’s one of the] things that you nurses had to do, [to] be good at putting gastric tubes in because we had to put tubes in and feed these people to bring them out of coma. Not only did we inject the sugar, but we also put a great big thick rubber tube down into their stomachs, and just poured it out of a jug, sugar, to wake them up from coma. So we did the same as that here . . . the tubes got smaller and smaller, and they

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introduced plastic tubes and this is ample to control the patients calorie intake. Because they don’t need greens, their metabolism is basal at this stage. So what do you end up with? A patient who has got a lot of their brain circuits effectively switched off. You’ve got off support systems running all over them, you’ve got all of this Olympic load, which is consumed. It’s loaded with anxiety, impulses. You’ve switched off all of the guard systems, the alerting systems, the perceptual inputs, and this is where a funny thing happens. When you wake these people up, you switch all these systems back on again. And of course, you know when you first turn the television set on, everything is chaos, there’s a moment or two before the picture straightens out? Do you see what happens when you [shift] these people out? Their perceptual inputs distort. And so when you first get them going again, they see that ward they are in as a charnel-house, as an executionist’s room, as a Mafia headquarters. And we’ve had over the years the most incredible hallu­ cinatory episodes in people when they first have their per­ ceptual machinery switched on again. And they’ll remember this, and we’ve tried various techniques and var­ ious ways to get them to lessen this. They remember nothing, of course, of the period they were asleep, but they remember those coming-out fears and perceptual distor­ tions. It would be possible to remove them completely, but it would make them, at present, it would make the tech­ nique a bit too complicated to add to it. It doesn’t do them any harm, but occasionally you get people who [are] deluded, and you’ve got to decontaminate them from these repeated ideas, from these distortions. Remember, you [are] a therapeutic task-force. So we ended up with people who had all these systems switched off, comparable probably to what happens when we sleep. Sleep procedure seems to be a therapeutic process. . . . And this deep sedation technique was [a] stage where it would switch off so much of the brain’s functions, that when you finally switch it back [on] again, it has a new bite, a new surge to get going, that’s one thing. Now you might think what’s it got to do with the junk­ ies? Early in the piece, when we started doing this in those

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early days, we got, accidentally, a few patients who were the most frightful pisspot booze artists you ever saw in your life, who were also depressed. They always had necks like bulls, and we could never get sense into them, and they were red-faced, authoritative, hypertensive, their livers were pul­ sating out here somewhere, and we were foolish enough to give them deep sedation. But we found that a few of these people after the treatment, didn’t want to drink. Here was a crazy thing, because what would, ... in the name of medi­ cine make people not want to drink? And, if we took them down deep, really hit them hard, they didn’t want to smoke . . . Well now, there was a — this goes back now, to Amer­ ica, when I was working in America, in New Orleans — there was experimental work being done there on cats, where they had found that if you put electrodes down on the anterior part of the brain, in the septal region between the two hemispheres and down, right deep down, sort of here, [if you] put electrodes in here, . . . you struck a [place] which had something to do with screwing and orgasm and pleasure and satisfaction. If they put a wire in this [area of the cat’s brain] and [attached] it to a push button, the cat would very quickly know that if it pressed the button, it [would get] a little “chop”, and this was a sort of a little orgasm. And so the cat would go pop again, and get the taste of it, and the cat would go pop, pop, pop, pop, pop. Here was something important. What [was one to] make of it? So, in New Orleans ... it was cheaper to use nigger[s] [sic] than cats, because they were everywhere, and cheap experimental animals [were hard to find], so they started to use them, Negroes and patients in hospitals, stimulate and so, the same area, little box was put on their paws with a button, they just went around pop, pop, pop, all the time continuous orgasms. So here was something new. So [per­ haps they had found], a centre [of the brain] which had to be satisfied all the time, and it was postulated that perhaps this centre had to be satisfied all the time . . . Like, threequarters of the world’s population are caffeine addicts. “Gotta have a cup of coffee, I’ve gotta have a cup of tea, I’ve gotta have a Bex, I’ve gotta have a Vincents.” All [that] caffeine. Those of us who are not caffeine addicts perhaps have opium in one form or another, or other euphoriaproducing substances, [or] nicotine. What is being stimu­

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lated? It is more probable than not that it is the little pop, pop, pop, pop, to produce that. This was the carrot that was in front of the animal’s nose, you see. If you didn’t have orgasms, nobody would screw. But if you have orgasm, this works like a carrot in front of everybody’s nose, “Wow, wasn’t that a beaut?” [But] if you chucked every time, or the first time, you had a cup of coffee or tea, they wouldn’t make the stuff. It’s got to have this pleasurable effect. Now, this is what these junkie kids do, they hit that [pleasure] centre, those junkie kids [go] around pop, pop, pop, pop, pop ... If you did it to these junkies, would it stop them, the need to be a junkie? Well, it did. And in fact, if we did it seriously, — [which] means sort of setting up the hospital exclusively for this type of patient, and they’re not good patients, you know, they’re nasty little bastards — but if we did, we could unhook probably 80 per cent of these junkies. Real ones and the marijuana kids as well. Marijuana is equally or more dangerous than heroin because its effects are more subtle in the brain, but it still hits them with the pop, pop, pop, pop thing. Have you ever smoked pot? If you smoked pot, why did you smoke pot? They smoke pot for one really good reason, all these kids, because it distorts the time sense, it does what the deep sedation does when you’re going out, when you’ve got the perception distortions. Time drifts in and out, and if you’re talking, you think you might be talking for 10 minutes or 10 years, you don’t know, because your internal time clock is distorted by the alcohol [or the] substance, and there you are. And, therefore, if you’re screwing and you have an orgasm, it lasts for ten years. Boy, this is good value for money! And these kids, you see, they never had it so good, they load themselves up with their pot, screw the backsides off each other as long as they can. And that’s why you’ve got to stamp out pot, that’s why. That’s the problem, because it causes damage, [it] is a substance which damages DNA. Do you know what DNA is? DNA is . . . that’s right, this is the code substance of the cell. The spironucleus of the actual genetic code substance. This is tied up with the active mechanisms of the body. This is — I have a theory which I’m only saying inside this room, [as] it is completely unfounded, but I’ve got a theory that the reason why all these viruses are eating us up alive, now [we] know that

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they are really ruining us. The bacterial diseases spread by . . . But the viruses are out chopping us to pieces. It’s because these viruses are passing through all these potsmokers and developing greater malignity, simply because the pot-smokers have got very little immunity left. Now, that’s a crazy theory. But anyhow, maybe in 10 years’ time, we’ll see that. Very bad! So, anyhow, that’s why we use this technique for the junkies. Because, there’s no worry about the legal . . . and that all the vogue treatments, except this one that I’ve got now, would produce not better than 10 per cent. Now we could give a clear 60 per cent — probably better. So the technique has still got potential, going all the way back to the medical. It’s been ignored because it’s hard to do, it’s difficult, it’s hard nursing. This is hard, dirty, shit-covered nursing, and, but in the end result, it is quite extraordinary. So, what we’re working for now is one shot ECT, with a certain type of depression, give them one treatment, they get up and say . . . It’s poss­ ible. We’ve almost got it, . . . See, why have got to do it 6, 8, 10 times? Why? I mean why have we got to go step by step. Isn’t it possible to go “zoop” straight to the top, and do it right? This will be possible in your lifetime, I hope, . . . Of course in the meantime we’ve got our friends, . . . the con­ sumers, . . . out there who are people that scream in and out . . . who are now saying that, and most of them, like lawyers and authorities of various kinds, psychologists, scientologists, the school, the Church of Scientology wages constant war, as you know, with psychiatry . . . And so we’ve got this problem, of the opposition to shock treat­ ment as it’s called. I’m particularly careful to say this is not “shock treatment” that they get here . . . This is high fre­ quency technique . . . There’s been lots of arguments over the years, what, how does ECT work? A lot of evidence points to the fact that it stimulates some of the circuits associated with the thalamus and the hypothalamus, because we could find in the blood of patients who had just had electrotherapy changes in cells, and some blood cells, immediately after treatment, showed some sort of hormonal discharge has taken place somewhere, presumably from the hypothalamus. But the interesting thing is that you always thought the step was the fact that you were . . . round about six, seven or eight, you

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start to get a plateau effect . . . you do two or three. But from time to time, you will see something. And of course, [there are] all sorts of crazy paradoxical things. Why is it that this has been a stumbling-block in many ways with manic-depressives? With the person who’s been in deep depression? Why is it that the treatment for deep depres­ sion, which is electrotherapy, is equally effective for hypermania, where you give ECT for hypermania two or three times a day, 10 times a week and then you stopped . . . Many psychiatrists of recent generation, of course, do sloppy kind of reasoning with Lithium, like any other patient, “If he gets depressed, let me know.” But he just doesn’t. It works fine for hypermania, but it won’t work if you’re depressed. But you’ll see patients all around town, loaded to the eyeballs with Lithium, who are depressed. It’s one good way of keeping them depressed, in my opinion. So unfortunately, you see, we’ve had a change [in] the development of psychiatry in the last 10 or 15 years, because from the time (Lauer Frank) developed group ther­ apy, this new approach swept through into hospitals throughout the world. It’s a terrifically labour-saving device. He would get 10 or 12 patients into a room and let them all go full-bore. And for certain types of people, who needed to act out or to be exhibitionistic, group therapy was terrif­ ically useful. But as a general magical cure for every body, it was a load of nonsense. . . . And we’ve still got people who wouldn’t know how mono-amine oxidase [sic] inhibitors work. But they’re terrifically good on various types of group relationships and so on. Well, this is fine, and in mental hospitals generally, the emphasis is to . . . because you see, [in] mental hospitals people don’t develop, and that’s the big thing. When you get out into private practice, where you’ve got, you know, $45-$50,000 rent to pay a year before you start eating, you can’t muck around and just hope that the therapy’s going to work. It’s got to have a much higher chance of success. And so, it’s important that people, that doctors and the like people, should know these modern psycho-pharmacological drugs, these psychotropic drugs, and know them backwards. And it’s important that the nursing staff institute . . . These drugs are, see, we’ve got to the stage now, they said oh, don’t give me drugs, doctor! Don’t give me drugs, do anything to me, but don’t give me

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drugs, with a capital “D”, even though society may not agree. “Of course, I’ll go and have a squash to recover from this.” And the idea is that [the drugs] go in in some sort of form through their body. They forget that anything that passes through their gut goes into chemical solution anyway, in their bloodstream replacing one chemical with another, providing that the chemical is properly selected and has got some useful therapeutic effect. So it’s very hard to get over this consumerist attitude amongst patients, which has been deliberately exploited and sort of developed by people, the people who encourage this notion that people should not take drugs, and this is a monstrous problem. Nevertheless, we are in an age now where we’ve got some very beautiful chemicals that will allow us to produce very stylish results in people’s mental function. That’s been coupled, of course, with this programme of psychosurgery that we’ve done in Sydney. In the 1970s we’d done the largest in the world, or the fourth largest in the world, with this cingulo-tractotomy series. But, in effect, we’re still doing the same thing with the cingulotractotomies except we’re going straight into the switchboard of their brain and after we’re directly there, instead of sending chemical messengers through the switchboard or electrical pulses this way. We’ve done about 300 cases, I suppose, of cingulo-tractotomies and about 15 or 16 multiple-target operations. And [a] multiple-target oper­ ation is much more complex, because we’re putting six lesions into the brain, three on each side. And the people we’ve been picking for this operation have been really the bottom of the can. Nothing’s going to help them, [to] shoot them is the only thing [to be done]. But, of the ones that we’ve sent across to America to have this done, we’ve got four or five or six of them that are positively getting better, and getting better by the months. . . . You might say “Yeah, what about [M.C., another patient who cannot be named]?” Too early, we can’t see good results from cingulos in obsessive-compulsives under six months, because the mechanisms, the obsession is full­ blown, and so ingrained and so patterned in his brain, that it takes quite a while to disrupt it. So it’s a bit hard to say whether it is, in fact, an incredibly good result, but you

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can’t really tell, you first have to see. That little boy . . . he’s a history-making case, he’s the youngest patient that’s been done in this hemisphere, I think. ... Now, he was a grossly distorted child, we sent him around to all the experts first before we operated, and all the experts made him worse. And [so] we operated, [and] his IQ has come up something like about 30 points ... So [C.M.] is getting a job, she’s slimmed down, she looks beautiful, she hasn’t got her symptoms since she left home. She was the first we’d even tried because she was only 14 or 15, and [we] waited to see what happened to C. before we did the other nine. So, perhaps we would be better doing more of these disturbed children, really, [to] give them a better chance, rather than let them go around the mental hospitals. [C.M.] was in and out of hospital a lot. She’s terrific, she’s got so brown, she really looks lovely. And her mother’s tickled pink that she’s doing a tech, course at Maitland Hospital. She wants to be a nurse. So the psychosurgical programme has paid off. The con­ sumers, the authorities. See, this is my other hobby-horse see. Once upon a time in medicine, we had the medical team consisting of doctors and nurses. These people had traditional orders. This is necessary, the whole impact of this has been the joint approach between the doctor and the nurse. And so it was, until relatively recently. We also, in the hospitals, we used to have fat elderly ladies down — the wards were in the basement of the hospital — called almoners . . . And if you couldn’t get a place for some kids to stay, you saw the almoner. Magically, she picked up the phone and dialled. And that’s how a hospital would be. They had a pharmacist who mixed the drugs, and that was that. Now this gets bigger and bigger. Everyone wants to be a doctor. And of course, this has spread to the society in which we live. If you dare get a symptom, you will be barred by your milkman, your drycleaner. All of your aunts, uncles, nieces and nephews, everyone will give you an accu­ rate medical diagnosis and classical symptoms. The only thing that’s holding up most of the community at the moment in their plan for everyone to be a doctor, is that they can’t quite handle the surgery. If they can only find a

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way of handling the surgery, that’s it. You can have your appendix taken out by the cook. As a result, nurses get put down by this, just as much as doctors do, and you know, you’ve got to oppose [it]. Nursfing] [is] a special kind of profession, and I have always regarded nurses as equal part­ ners in the same team. They should make themselves as much aware of the clinical situation as the doctor. God knows, in teaching hospitals you had to take orders from the sister in charge of the ward. So there’s a tendency always these days amongst this plan of therapy where everyone’s a doctor, that nurses will go as well. The nurses run the systems and wear shift clothes. The fact that they’ve shortened the nursing training now, well, that might be a reasonable thing, because a lot of nurse’s training is, or training period is, taken up here. But the fact remains that, while the practice of medicine is still not in the hands of the social workers we still need nurses who ought to be technically competent. In this hospital, more so than any other hospital, because this whole prin­ ciple that I’ve been telling you about, this deep sedation technique, depends entirely on the skill and expertise of the nursing staff, which is as it should be. I expect that nurses should be able to give intravenous injections, should be able to put catheters in. . . . Because, you see, the moment the question of responsibility comes up, then they run like crazy, you know “Doctor, oh, that’s your responsibility, doctor, you signed the death certificate”. So someone said these people don’t want to throttle responsibility, they just want to turn it upside down. The buck has to stop some­ where, somebody has to sign the death certificate. And this has got me into trouble over the years, with many of the authorities around the place, because I have over the years allowed nurses here to make these decisions.

CHAPTER 11

THE WALLS CLOSE IN

So it was in 1978 that Bailey for the third time in his life was forced to cease an activity that he regarded as being an expression of himself. On each occasion it had been brought about by his own excesses and his inability to face reality. Twenty years earlier his exaggerations had led to a finding in the Callan Park Royal Commission which although support­ ing him in principle, made it obvious that he was not suited to a position which required a sense of balance. Next, he had been prevented from pursuing his interest in psychosurgery, first, as a result of his failure to accept the generally approved standards of medical research, and secondly, as a result of legislation, passed by the New South Wales Government in 1978 which seemed to be a reaction to his excesses. Finally, his exclusion from Chelmsford represented a rebuff that was to cause him enormous emotional distress. At the time his per­ sonal affairs were in tatters. He was furious at the publicity he had received following Sharon Hamilton’s suicide in 1978, and he was jealous of Jan Allan’s new boyfriend. Another former patient (who cannot be named) with whom he had had an affair also committed suicide around about this time. By the end of 1978, following his separation from Jan Allan, Bailey had established another relationship, this time with 25-year-old Helen MacArthur. Initially they lived apart. She was studying for a degree in Business Administration and found it impossible to study if they were living together. At times she would act as hostess for Bailey, but at the end of the evening she would return home. Sometimes Bailey’s female guests would spend the night. In 1981 MacArthur became Bailey’s secretary. She had completed her studies and they began to live together on a full-time basis, moving finally to 10 Rogers Avenue, a run-down house next door to the peren­ nially unfinished Mandala. Despite his professional troubles Bailey began to renovate this house. He pulled out walls, 139

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retiled the bathroom, put in a spa bath, which required an alteration to the floor because, as it was, it would not take the extra weight. He rebuilt the fireplace. The house needed rewiring and Bailey’s one concession to the law was that he hired an electrician to help complete the work. But the detail of the electrical work was never finished and there remained a mass of wires running along the walls and held together with tape. Typically, Bailey had not bothered to obtain Council approval for these major renovations because ‘he felt he would not be around by the time they found out’. For the five years Bailey and MacArthur spent together, 10 Rogers Avenue remained unfinished and in a constant mess. Bailey and MacArthur had an unusual living and working arrangement. Bailey’s heavy drinking made getting up to go to work difficult. MacArthur would set the alarm for herself, drive to the city, open the surgery, then telephone Bailey to wake him up. Bailey always refused to answer the telephone so MacArthur allowed the phone to ring twice and then hung up. The size of Bailey’s practice had decreased during 1981-82, so MacArthur didn’t take out any wages for herself. The ‘matrimonial’ home was maintained out of petty cash and recorded in the ‘books’ as practice purchases. Throughout 1979 the prospect of Deep Sleep Therapy being analysed by a court, at the forthcoming case brought by Hart against Bailey’s long-time colleague John Herron, created further apprehension. When it became apparent that he was not to be given the opportunity to explain his treatment, even though it was this treatment that was under attack, he again felt insulted. Although he had built up a substantial patient list and was able to maintain his practice, he now seemed largely disinter­ ested. He had given up smoking just before his breakdown, but had replaced tobacco with alcohol. While Herron was treating him with antidepressants he had been forced to abstain, but by the end of 1979 he was drinking heavily. The Church of Scientology saw him as psychiatry’s Achilles Heel, and marshalled all their public relations skills in an attempt to keep his name and his excesses before the public. Even before the Hart case came to court, three banner head­ lines about Chelmsford and Bailey had appeared. In the 22 October 1978 edition of the Sunday newspaper a

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‘ “Zombie room” outrage at hospital’ headline appeared. Hamilton’s death produced ‘Pregnancy claim in dancer’s will’, and then the more damning ‘Doctor named in lover’s will’. It might have been anticipated that when Hart’s case came to court all the abuses of the Chelmsford affair would be revealed. Unfortunately the judicial process prevents an inves­ tigation of anything that does not relate specifically to the complaint at hand. Understandably, Herron’s counsel were anxious to keep Bailey’s name as far as possible from the jury, whilst Hart’s counsel tried its utmost to show that Hart’s treatment was just part of a tragic pattern. Apart from the claim by the defence that the treatment was not negligent, they were anxious to portray the case as a Scientology plot against psychiatry in general. Although the case was against Herron, it was obvious that success by Hart would open the door for many more actions against Bailey, and Herron’s insur­ ers were keen to make it clear that any potential litigant would have to fight very hard in order to succeed. At this stage only Bailey and Herron knew that Hart’s treatment was not an isolated event but, as was found later in the Chelmsford Royal Commission, was representative of many other instances in which patients were given treatment without properly obtained consent. When the jury found in favour of Hart it was just a question of time before other patients brought actions, opening the way for the various authorities to investigate the whole saga. As Bailey’s world tumbled down he looked for people to blame. In moments of rage — usually when he was drunk — he would rant about the evil of the scientologists. He could not understand why they had singled him out as their target, yet typically, he failed to look hard at his own behaviour. He seemed unable to correlate his own actions with those he knew were appropri­ ate. On numerous occasions he had both written and spoken about the standard of care necessary for the maintenance of his Deep Sleep programme, yet he failed to take even the most minimal steps to ensure that these requirements were met. It was as though saying something meant that it was done. He had often spoken to Jan Allan about the need for honesty and morality in the world, yet he had behaved in a manner diamet­ rically at odds with his statements. Even as his problems were closing in on him he still flaunted his ‘independence’ and refused to conform. In 1975

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he had been reprimanded by the Health Commission because he was selling drugs to his patients from his practice. Yet in 1979 he was continuing to do this even though he was well aware of its illegality. He was only allowed to provide a patient with three days’ supply of medication, but Bailey was quite happy to sell medication to his patients in packets of 250. During the 1982 financial year Bailey purchased about $10,000 worth of drugs which he then sold from his practice. There is certainly no allegation that Bailey made a huge profit from this illegal scheme, but it did make it attractive for patients to return for a consultation and pick up a supply of their medi­ cation at wholesale rates. The drugs he sold were always those which were not available on the government-subsidised national health scheme. They included Serepax, Parstelin and Marplan. Patients were able to obtain these drugs without a formal prescription being written. At times he would write a prescription, and the patient would leave his rooms with a supply of the medication plus the prescription. Bailey’s hap­ hazard methods extended to the storage of his drugs. They were not kept in a locked cupboard and anybody who entered the surgery could have had access to them. The practice made no attempt to keep a separate drug register and the only records that were maintained were the purchase invoices from the drug suppliers and the patient’s files. Sometimes medica­ tion would be sold to a patient who had not come to the surgery for a consultation but had only come to purchase cheap drugs. This system had been in operation for many years. The jury finding in Hart’s case prompted the CCHR to intensify its campaign. It provided Sydney’s Channel 9 tele­ vision station with many of the documents it had received from Rosa Nicholson, which led to that station’s influential current affairs programme, ‘60 Minutes’, going to air with an award-winning programme called ‘The Chelmsford File’. A nationally broadcast show, ‘60 Minutes’ revealed that at least seven people had died between 1974 and 1977; that recognised standard precautions for the safety of the patients were not taken; and that patients received the treatment with­ out their consent. The programme also devoted much time to the death of Miriam Podio, who died in August 1977, and who, it was claimed, received the treatment for a period of 11 days even after it had become clear to everybody that she was

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desperately ill. Not one member of the psychiatric profession was prepared to be interviewed on the programme. The publicity made it politically impossible for the govern­ ment to ignore what had happened, with the result that dif­ ferent departments instituted investigations. Delays in the commencement of these official investigations played into the hands of the CCHR and they flooded the authorities with correspondence. In October 1980, Dr John Sydney Smith wrote to Sir Martin Roth, Professor of Psychiatry at Cam­ bridge University, seeking advice about the whole matter. Sir Martin replied: The inhumanity and cruelty to which the patients appear to have been subjected is quite unique in my experience, and the Scientologists and other organisations will have obtained ammunition for decades to come. There is there­ fore a pressing need for maintaining strict confidentiality at this stage until one can set these unique barbarities in the context of contemporary practice in psychiatry in a care­ fully prepared statement that comes from colleges and other bodies concerned. Following the ‘60 Minutes’ programme letters were written to the Premier of New South Wales, Mr Neville Wran, who replied that the Minister for Health, Mr Kevin Stewart, had the matter in hand. The Attorney General, Mr Frank Walker, also wrote to the Health Minister requesting an urgent inves­ tigation. Everybody promised action but nobody seemed to know what to do. In an attempt to get the authorities to act, the CCHR lodged a formal complaint against Bailey based on his treatment of Miriam Podio who had died in August 1977. In the meantime, Dr Smith and Mr Edward St John QC, who had been senior counsel for Hart, had written to the Royal Australian and New Zealand College of Psychiatrists request­ ing that they review Bailey’s and Herron’s membership of the college, and suggesting that the college take formal steps in association with the Medical Board with the aim of disciplin­ ing them both. Nothing was done, although by mid-1981 investigations had reached the stage where expert opinions were being sought about the death of Miriam Podio. On 2 February 1982, an inquest into the cause of her death was

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opened. On 4 March the Coroner, Mr Terry Forbes, termi­ nated the inquest after finding that ‘there was a prima facie case established’ in respect of the three doctors Bailey, Herron, and Gardiner. Another ‘60 Minutes’ programme went to air in which the circumstances of the death of another patient were presented with a report from an expert who said that, bearing in mind [her] symptoms, ‘she should never have been subjected to this kind of therapy’. Bailey was now totally beleaguered. He sent a circular to doctors: In recent months you have observed a fairly intensive cam­ paign of vilification and denigration, which some of the media have directed at me and my colleagues . . . This girl had been taking twice the normal dosage of [a] high oestrogen pill and was a heavy smoker. [She] died of a sudden pulmonary embolism . .. Since then it has been “trial by media” with the implication that somehow I and my colleagues were responsible for this girl’s death. This technique of arranging a trial by media is a common one for Scientologists to use, and one of our neurosurgical col­ leagues in California, Dr Hunter Brown, has been through an exactly similar experience . . . Over a thirty year period I have treated approximately 5000 patients with ‘deep sed­ ation’ therapy with more than 85% recovery to normal mental health. There were about 10 deaths in the series, none specifically due to the treatment but to factors such as staphylococcal toxaemia. Even at this late stage he was still trying to bluff his way through. He exaggerated the number of patients and claimed a cure rate for which there was no means of substantiation. In not one of the death certificates that Bailey completed did he give the cause of death as ‘staphylococcal toxaemia’. He knew that his word would be accepted before that of the Scientologists and that the charges they brought were so hor­ rendous that his colleagues would have difficulty in accepting them as true. Even though Bailey was receiving constant adverse public­ ity, some general practitioners still referred patients to him. His exclusion from Chelmsford and his inability to gain access to any other hospital meant a change in the way he conducted

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his practice. He was forced to rely more on analytical treat­ ment in combination with the use of standard drug therapy. On 9 March 1983, Bailey was charged with manslaughter after investigations into the death of Miriam Podio. The NSW Director of Public Prosecutions had decided not to proceed with charges against Herron and Gardiner. Bailey was asked by his lawyers to provide a statement about the way in which the treatment was carried out. Once again he set out in the state­ ment a series of ‘facts’ which we now know were untrue. For example he claimed to have provided the treatment for 5000 patients when in reality the Chelmsford Royal Commission revealed that he had treated just over 1000. He claimed that the patients were treated in a ward ‘where intensive care facilities exist’, although this was not the case (Herron, at the Hart u Herron trial, had said that intensive care was neither necessary nor present.) Bailey claimed that barbiturate blood levels were taken regularly although even a quick scan of the records shows that such was not the case. It certainly did not occur with Miriam Podio. He claimed that the patients were always supervised by a trained nursing sister, when they were often left to the care of nursing aides. He claimed that a full physical examination was always carried out prior to the com­ mencement of the treatment, when on many occasions patients were sent to Chelmsford without having ever met Dr Bailey. He claimed that in 30 years he had never seen one instance of bed sores, yet the patient nursing notes reveal that, while not common, they were a recurring problem. He claimed that he maintained a constant course of instruction for the nurses, when in fact the only lecture he gave was the one that had been organised by Rosa Nicholson in her attempt to gain information about Deep Sleep. He claimed a minimal incidence of pneumonia, although an analysis of the nursing notes of the patients indicates that nearly 6 per cent of all patients suffered from this complaint. The committal proceedings against Bailey relating to the death of Miriam Podio commenced on 7 November 1984. Bailey’s physical appearance showed the strain of the previous few years. He bore little resemblance to the confident young man who had been hailed as the saviour of psychiatry 25 years before. He no longer approached the prospect of an appear­ ance in the witness box with the air of jaunty confidence he had affected when he was at his most popular and in constant

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demand as an expert witness on psychiatric matters. He had grown fat, was heavy jowled, wore a perpetual sour scowl, and his eyes had a hunted look. Far from giving the appearance of a latter-day Sigmund Freud, he looked like a tired, angry old man. His miserable appearance was not helped by the contrast between Bailey and the young woman, Helen MacArthur who sat by his side during each day of the hearing. Bailey’s defence counsel concentrated on one main issue. In order to sustain the prima facie case necessary, the crown prosecutor had to show the precise cause of death. Bailey’s defence counsel was Mr Ian Barker QC, who had gained national prominence following his prosecution of Lindy Chamberlain in the internationally famous ‘dingo’ murder case. Barker submitted, that, from the facts as presented, it was possible to choose from 14 different causes of death. These included abdominal catastrophy, ruptured appendix, toxic shock and septicaemia. His case was assisted by two important factors. Bailey had failed to comply with the requirements of the Coroner’s Act: Miriam had been uncon­ scious immediately prior to her death which should have been formally reported to the Coroner and there should have been an inquest. In its absence this left Miriam’s parents free to take her body to Italy for burial soon after her death in 1977. Had Bailey obeyed the law at the time of her death there would have been an investigation into its cause, and a post-mortem examination could have been carried out. In the absence of the body the committal proceedings became a matter of pure speculation. That the treatment contributed to her death was not legally sufficient to sustain the charge, even though there was a mass of expert testimony which stated that this was the case. Pro­ fessor Denis Wade, Professor of Pharmacology at St Vincent’s Hospital, who had been called as an expert witness in Hart’s case against Herron, gave evidence that the ‘administration of what I regard as massive doses of sedative contributed to her death’. Dr Ross Beresford Holland, Director of Anaesthetics at Westmead Hospital, said he believed that the sedatives, which were an integral part of the Deep Sleep programme, had the effect of masking Podio’s symptoms of pneumonia. He found no evidence that would enable him to conclude that Miriam had died from a pulmonary embolism, the cause of death claimed by Bailey. During the hearing, evidence about the way

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in which Deep Sleep Therapy was carried out was given by a number of nurses; the most poignant testimony coming from untrained nurses who had made decisions about the admini­ stration of dangerous drugs without any specific authorisation from Bailey. The nurses’ lack of training did not allow them to take into account the vital fact that the drugs Podio was given interacted with each other, and had the effect of increasing the lethal effect of the combination. Even if the opinions of the experts were accepted, Barker claimed there was no evidence to refute Bailey’s assertion that she had died from the embolism. On 9 May 1985, the magistrate, Mr Derrick Hand, dis­ missed the manslaughter charge against Bailey. He found that it would not be possible for a reasonable jury to conclude, beyond a reasonable doubt, that Bailey had been criminally responsible for the death of Podio. In arriving at this decision the coroner made it clear that he thought poorly of the stan­ dard of treatment that had been provided by Bailey: The defendant’s overall supervision of the patient has been most negligent, in my opinion, having regard to the type of treatment being carried out, and his action overall in regard to the type of treatment and the subsequent signing of the death certificate and the non-report of the death in accord­ ance with the Coroner’s Act. Although he had managed to ward off the criminal charge Bailey’s problems were by no means over. There were two other actions pending in two separate jurisdictions. Jan Eastgate, now the head of the CCHR, had watched the com­ mittal hearing with intense interest, and had lodged a disci­ plinary action against Bailey before the New South Wales Medical Board’s Investigating Committee. Bailey had lodged an order to restrain the hearing into the disciplinary matter until the outcome of the manslaughter charge had been heard, but it was now able to proceed. Eastgate’s almost daily pres­ ence at the committal hearing while her complaint against him was pending, further fed Bailey’s paranoia about the Scientologists. He subsequently wrote: The Scientology cult has used the same technique against specialist psychiatrists in Los Angeles and New York. Their

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pursuit of psychiatrists arose from a directive from the cult’s founder, one L. Ron Hubbard. The Scientologists derive their income from the mentally sick, using an escalating technique to extract money from these people. One of my patients paid them $6000 after two weeks, and another handed over the deeds of his house after a few weeks. Bailey wrote a reply to the Scientologist’s complaint to the Investigating Committee. Included in this reply was a curricu­ lum vitae. His statements in this reply could only have been figments of his imagination. He gave a figure of 1 death per 100,000 patients in the period prior to 1973. In fact 14 patients had died at Chelmsford while he had only attended less than 1000 patients by this time. The pneumonia rate he put at 5 in 10,000 whereas in reality it was nearly 6 in each 100. He claimed a total absence of any brain damage or serious morbidity. He claimed that oxygen was constantly ‘running’ when ECT was given. This was also untrue. During 1984 Bailey and Chelmsford had become a political issue. Mr John Hatton MP raised the issue in parliament on 17 May, asking why it was that everything about Chelmsford was taking so long to come to a conclusion. On 29 May Eastgate made application in the Supreme Court of New South Wales for a Writ of Mandamus, which calls upon the Investigating Committee to carry out its statutory function and ‘investigate’. In September 1984 Mr Pat Rogan MP made the first of many speeches in parliament calling for a full investigation, and a headline in the Sydney Morning Herald reported the speech as ‘MP seeks inquiry on a litany of suffering’, further reporting that Rogan had called for a ‘full level government inquiry’. Throughout 1984-85 there were almost daily calls on radio, television or in the press for a formal inquiry with preference being expressed for a Royal Commission. In March 1985, the Medical Investigating Committee found a prima facie case against Bailey. A Sydney Sunday newspaper reported that there was an on-going police investigation into 12 alleged Chelmsford deaths. In the New South Wales Parlia­ ment Mr Rogan delivered his most powerful speech about Chelmsford, calling it a ‘hell-hole’. He castigated those respon­ sible for the regulation of, and the investigation into, Chelmsford. He said that all the relevant authorities had

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known what was going on but nobody had done anything to halt ‘the appalling mis-treatment of patients’. Even though Bailey was under siege and his finances suf­ fered as his practice reduced in size, he had always felt secure that he would be able to afford the best legal representation and be able to meet any damages claim that might succeed against him. Along with all other doctors Bailey had taken out ‘indemnity’ insurance with one of the medical defence associ­ ations operating in Australia. Bailey had selected the Medical Defence Union of New South Wales. This organisation had long advertised that it was to be preferred to other similar associations because it guaranteed to represent a member, meet any legal costs and to pay any award of damages. The Hart case, with the enormous cost its 78 sitting days incurred, and the subsequent realisation by the organisation that it was not a ‘one off, prompted them to call a general meeting to change its Articles of Association. The purpose of the meeting was to give to the directors discretion as to whether or not they offered support for any doctor member. This change was auth­ orised, and within months Bailey had been notified that the Medical Defence Union was considering withdrawing its sup­ port. Bailey was now effectively left to his own devices. He wasn’t sure whether or not the Medical Defence Union (MDU) would pay for his defence at the committal hearing. He was forced to find approximately $50,000. He had received a sum from an insurance policy held by his late father, as well as insurance for the loss of property stolen from Rogers Avenue. This money he passed over to his solicitor, Jack Levy, who used it to pay the legal expenses for the Podio committal hearing. The MDU subsequently agreed to meet the costs and Bailey was reimbursed. The conclusion of the committal hearing did not spell the end of Bailey’s troubles. His health was poor and he was admitted to hospital suffering from pneumonia. According to Helen MacArthur he was taking medication for a heart condi­ tion and he had developed an allergy. He sneezed constantly and was thoroughly miserable. The disciplinary proceedings that were being brought against him were now being coordi­ nated by the head of the newly created Medical Complaints Unit of the Health Department, Merilyn Walton, and would soon come to a hearing. The unit had been set up as a vehicle

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for patients to express dissatisfaction about their medical treat­ ment and to investigate their merit. It was only as a result of the creation of the Complaints Unit that there was any effec­ tive official action. Added to this, Bailey was, for the first time, being sued by a former patient, Patricia Vaughan, who had suffered brain damage following her treatment at Chelmsford. This case was due to be heard in September 1985. During preliminary consultations with his legal advisers Bailey had, as usual, asserted that the damage suffered by Mrs Vaughan had not been caused by the treatment she had received at Chelmsford. Unfortunately for him, both the findings of the Hart case and a collection of expert opinions were at odds with his view. In evidence given at the Chelmsford Royal Commission it emerged that counsel, John Sackar QC advised the Medical Defence Union as follows: The plaintiffs case here is broadly either that the Deep Sleep Therapy, together with the ECT, was totally inappro­ priate, or that it was not carried out with the proper pre­ cautions being taken. In the previous case of Hart v. Herron, the nursing staff on one view was totally unqualified. Expert evidence called for Mr Hart suggested that the deep sedation ward should be run along the lines of an intensive care ward both in terms of skill of the nursing staff and the equipment avail­ able. No doubt, in this case, the plaintiff will call the same sort of expert evidence. There is no doubt that at 7.30 a.m. on 11 October, Dr Bailey decided that Hornsby Hospital was better able to cope with Mrs Vaughan’s complications. This in itself was an admission of the inadequacy of the facilities at Chelmsford Hospital. The difficulty in this case is that it is most unlikely that any expert evidence will be available for Drs Bailey and Gardiner . . . Further it is clear when one makes a compari­ son between the form of treatment undertaken by Bailey, and the description given to Deep Sleep Therapy in Dr Sargant’s 1973 paper on the subject, that Dr Bailey’s treat­ ment was different in a number of material respects . . . There will no doubt be a real dispute in the case as to whether Mrs Vaughan was a suitable candidate for the treat­ ment in any event. In all circumstances, in my view, the plaintiff in all prob­

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ability will succeed on one or more of the negligence counts against Dr Bailey and/or Dr Gardiner. As to the relative liability between Gardiner and Bailey for Mrs Vaughan’s damage, counsel advised: One of the real difficulties of this case, of course, from the defendant’s point of view, is having labelled Mrs Vaughan a psychotic who was thought disoriented and delusional. It may be very difficult for a jury to accept that Mrs Vaughan was actually consenting to whatever Dr Bailey says he explained to her . . . ... in all probability [Dr Bailey would bear] the brunt of any verdict given ... It was [Dr Bailey] who after all mas­ terminded the regime, commenced it and, for the most part, supervised it. He was there at the beginning, and he was there at the end. This advice to Bailey’s lawyers made it plain that he could look forward to a lifetime of litigation brought against him by former patients. It also revealed the rather contradictory role which is often forced upon legal advisers. The foundation of Herron’s defence was the similarity between his treatment of Hart (which was virtually identical with Bailey’s treatment of Vaughan), and Sargant’s recommendations. There had been no new medical information about the comparison between the two systems since Hart’s case had been heard. Not even his insurers, who had the greatest interest in at least showing that Bailey could be right, held out any hope. His absolute rejec­ tion was now complete. Bailey’s traditional safeguard, created because all his patients were spread throughout the city and had no contact with each other, was ended with the formation of an organisation called the Chelmsford Survivors in 1983. Its driving force was Barry Hart. He thought that as a group the former patients of Chelmsford would have more success in publicising their grievances than would any individual. Bailey knew that he would be forced to meet some of the costs of the forthcoming trial and he was anxious to ensure that his assets did not find their way into any future settle­ ment. Against legal advice he took steps to divest himself of his property and transferred it to Helen MacArthur and his

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two daughters, backdating the documents because he thought he had nothing to lose. As Bailey’s problems grew worse his health deteriorated. He became morose and maudlin. He spoke of himself as ‘the mad doctor of Chelmsford’. He started to talk seriously about committing suicide and Miss MacArthur was scared to leave him alone: ‘I really found the last 12 months of my life with him quite stressful’. When­ ever she found it necessary to go out she recruited friends to act as ‘babysitters’ because she didn’t know what he would do. MacArthur and Jan Allan had become friends, and Allan was a frequent visitor to their home. Bailey seemed to appreciate this and in a strange act of sentimentality purchased them identical presents. Each received a Siamese cat and a pearl ring. Prior to the culmination of his troubles Bailey had spoken negatively about suicide as a solution to problems. He told Allan that he didn’t believe in suicide. ‘He would say that people would always get better if you help them, and he said the only justification for suicide was a man with no limbs in a burning building.’ His attitude had changed by the time he had begun to live with MacArthur and he told her that if he had terminal cancer he would take his own life. These conver­ sations were repeated, but ‘it was not until much later that he was more definite about it and I realised that he was probably serious’. Sometime in August 1985 Bailey and MacArthur visited Allan: ‘he arrived laden with champagne and prawns and he was “off his face”. He was so drunk. Helen was trying to keep him under control. He had a knife he was doing something with and he cut his hand. We [both] hoped he wouldn’t, but I think we knew he would kill himself.’ Bailey had often told friends it was a cause of distress to him that he believed he was unable to have children; and those close to him were aware of the fact that his daughters were adopted. Both Bailey and his wife had decided that they were not to be told of their adoption. Mrs Bailey was extremely upset when he called the girls, now 29, together, and gave them this information. On Sunday, 8 September, Bailey had a conference with his legal advisers. The Vaughan case was to open the next day. At the conference he had been told that Dr Sargant had been

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contacted in England and that he was not going to support Bailey’s treatment of Vaughan. In a statement to Bailey’s legal team Sargant had written: If I had come over to Australia to give evidence on oath, I would have to have said that the technique used by Dr Bailey in feeding his patients through a stomach tube and not waking them to take three full meals and fluid each day, was what had resulted in the death of my earlier patients. In fact, I should have found myself supporting the prosecution and not the defence. Bailey arrived home after the meeting and told MacArthur ‘it’s not worth going on’, then later walked out the door without another word. Allan had been invited for dinner that evening. Following a telephone call from MacArthur telling her about Bailey’s sudden departure, Allan came over to keep her company. When MacArthur went to bed that night she found a note under her pillow. I have had enough. I learned today from Pavlakis that they have sent police to London to interview Sargant, etc. Prior to calling for a Royal Commission or whatever, it is a no-win situation for me, I have taken a bottle of beer to wash down the you-know-whats. Always remember that the forces of evil are greater than the forces of good. I have always tried to be a good doctor. I think perhaps I was. Remember the virus is trying to kill me anyway. Empty the safe quickly and relocate everything. Give my thanks to E.D. for everything. The next morning Davies, after being contacted by Miss MacArthur and told about Bailey’s actions and the suicide note, reported Bailey’s disappearence to the police. At 1 p.m. the next day Bailey was found by a highway patrol police car. He was slumped over the steering wheel of his car, which he had parked along an isolated dirt track at Mount White, an area off the northern freeway which runs between Sydney and

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Newcastle. He had drunk a cocktail of Heineken beer and Tuinal. Beside his body was a manila folder. In it was a note to Miss MacArthur in which he expressed his desire that she receive the house at 10 Rogers Avenue, Haberfield, and that the home at Piper Street, Leichhardt, be transferred to his wife. He concluded his life’s work, and apparently summed up his thoughts at that moment, with a poem by Swinburne entitled ‘Dolores’. Given the pressure he was under and his reaction to it, Bailey’s friends were more surprised at the way he had taken his life rather than that he had actually committed suicide. They were also surprised that he had chosen to wash down the tablets with beer rather than his preferred Glenlivet Scotch Whisky. Jan Allan has said that Bailey believed that it was mainly women who committed suicide by taking an over­ dose of drugs; at Rogers Avenue Bailey’s pistol, however, had been stolen during the robbery. The police contacted Helen MacArthur, who asked Bailey’s closest friend, Evan Davies, to break the news to Mrs Bailey. At his funeral, his long-time friend, Davies read a prepared obituary: Harry Richard Bailey was born in New South Wales, 20 October 1922 at Picton, and died on 8 September 1985 at Gosford. He graduated in Medicine at Sydney University in 1951, being awarded the Ian Vickery and the Norton Manning Prizes. Specialising in psychiatry, he was awarded the DPM [Diploma of Psychiatric Medicine] in 1954. The qualities of a good doctor were to be found firstly in being a good scientist, secondly in possessing technical effectiveness, and thirdly in being a humanist in having regard and concern for the well-being of his patients. Firstly, as a scientist, Dr Bailey made an outstanding contribution to Australian and world psychiatry. Originally trained in the Faculty of Science, he possessed an erudite knowledge of biochemistry, conducting the first clinical trials in Australia with Largactil, Nortriptyline, Fluphenazine and LSD. He published, with various co­ workers, a dozen papers in psychiatry, seven of which were devoted to depression, became well known internationally and, at the time, represented definitive research in the topic.

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His work in puerperal and post-natal depression led to the establishment of the first Department of Gynaecological Psychiatry at the Women’s Hospital Crown Street, and was later recognised by his winning of the AMA Gold Medal with his essay on sexuality. To this day, therapies developed at Crown Street have been adopted on a worldwide basis. Dr Bailey, by assiduous training and study, developed remarkable technical skills. In the 1950s the Health Depart­ ment had a blueprint for a neuropsychiatric institute. The first director, Dr Gibson from McGill University, after two years of frustration, left Australia. Dr Bailey had worked at Broughton Hall Insulin Clinic with its founder and Bleuler and Sakel in Zurich. At this time, the sedation treatment was the only known treatment for schizophrenia. During 1955-57 Dr Bailey held a WHO Fellowship which enabled him to study sedation methods with Sem-Jacobsen at the Mayo Clinic and with Sargant and Grey-Walker in England. He also spent a considerable period working with Lars Leksell in Lund, Sweden. Upon his return to Australia, the Health Department directed him to establish the proposed neuropsychiatric unit which was opened in 1959 as the Cerebral Surgery Research Unit. This clinic, at the time, was a high-tech institution that represented one of the best equipped clinics in the world. During the 1960s and 1970s, improving techniques in sedation therapy, Dr Bailey treated 2000 patients from both Australia and other parts of the world. All these patients benefited from the treatment. The alleged, but by no means demonstrated, 16 deaths associated with the treatment, show a mortality rate which is equivalent to psychoneurotic patients treated with any therapy, but it should also be remembered that these patients, in most cases, had tried other available therapies without success. Thus, they were patients who were seriously disturbed, suffering with excep­ tionally acute or chronic psychiatric conditions. In more recent times [1981], Dr Bailey was able to dem­ onstrate with studies of 1600 patients, the advantages of combining anxiolytics with anti-depressants in the treat­ ment of severe depression. As to his humanist affiliations, anyone who had the privi­ lege of working with him soon became aware of the fact

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that he did not spare himself in working for the well-being of his patients. His concern for patient well-being when he was Superin­ tendent of Callan Park led to the Royal Commission of 1961. The McClemens report changed the entire com­ munity attitude to mental health for all time. It established the scientific attitude to mental health in contrast to the custodial care which predominated in the not too distant past. In later years, when harassed with litigation, patients frequently wished to testify on his behalf. He knew that such publicity could not benefit the patients, and because of this forbade them to speak. As a scientist, Dr Harry Bailey made a major contribution to pyschiatric research. His technical dexterity led to the development of new therapies, several of which have been adopted world wide. His humanism is attested to by thou­ sands of grateful patients. He more than fulfilled the criteria for a good doctor. Historically, it is often the case that an innovator, imple­ menting the frontiers of scientific knowledge, and coura­ geously adopting new and radical techniques when only drastic measures suffice, evokes antipathy rather than appro­ bation. In his final days, Dr Bailey was harassed by the uninformed, the pyschologically disturbed, and by others who were antagonistic for reasons best known to them­ selves. Ave atque vale, Harry Bailey Ave atque vale. His friends remained loyal even after his death. MacArthur cleared out his surgery and Allan took time off from work to help. Allan took the brain that Bailey had displayed on his desk: All kinds of people were putting in their bids for it, but I thought, “No, someone special has to have this brain”, so I took it.’ Allan took it upon herself to tell those patients whom Bailey was still treating about his death and ‘they were angry that he had let them down in this way’. Commenting on the last few years of Bailey’s life Jan Allan said:

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He was clinically depressed and he couldn’t see any light at the end of the tunnel. I was angry with him, but he had had enough. The Scientologists killed him, let’s leave no doubt about that ... he just couldn’t understand why they picked him. When he got drunk he’d get angry about it and he’d get depressed. They just controlled all his thoughts for the last years of his life. All he thought about was what they were doing to get him, and after all, he was trying to help people. He was a man who was feeling wrongly accused and persecuted. If you are going to label him, I wouldn’t say he was a psychopath, more of a manic depressive in that when he was high he was very productive and creative and had great ideas, but when he was low he hit the bottle. I only saw him low at the end of his life and it was very sad and pathetic. A few weeks after his death Helen MacArthur decided to have a wake. She called all those who had worked in his rooms, and invited them to the surgery at 187 Macquarie Street. The surgery was entirely bare except for the desk which had been permanently attached to the floor. Jan Allan recalled, ‘We all went and drank ourselves silly.’

CHAPTER 12

BAILEY EXPOSED

On Monday, 9 September 1985, the case brought by Patricia Vaughan against Bailey went ahead as planned. Although Bailey was not in court, nobody at this stage knew he was dead. One month later Mrs Vaughan settled out of court for an undisclosed sum. When Bailey’s death was announced, it resulted in a flood of articles in the daily press about his life and work. He was variously labelled ‘Our Dr Strangelove’ and ‘Svengali’. One article began ‘Dr Harry Bailey, the man dubbed “Dr Deep Sleep” because of his notorious sleep therapy treatments, was a Jekyll and Hyde’. Through all the publicity his intimates attempted to pick up their lives. Helen MacArthur remained in a state of shock for some time. She did not carry out Bailey’s instructions to ‘relocate’ everything. She left the three safes that Bailey had installed at their home unopened. The $15,000 worth of pho­ tographic equipment which Bailey had purchased was collec­ ted by his son-in-law, Andrew Mueller. MacArthur believes that Bailey’s instruction to her was motivated by his belief that after his death his family would not remain friendly with her and that their sole interest in her was that she might have control of Bailey’s money. Bailey’s attempt to transfer his prop­ erty to MacArthur was subsequently challenged by the family and his wishes were defeated by a Supreme Court ruling. Despite her state of shock MacArthur recalled to a friend small, but to her mind significant, events, for example, walking to the local liquor store to make a purchase, and being told by the owner that there was a ‘special’ on Scotch whisky, the owner being sure she would be interested because of the copious amounts she had been purchasing. It was only then that she realised they thought that she was the person who had been consuming it all and she felt constrained to tell them, ‘I don’t drink it’. 158

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Together with Jan Allan she remains fiercely loyal to Bailey. Bailey’s death did not end calls for a Royal Commission into Chelmsford Private Hospital. The removal of the restraints of defamation laws imposed on the media while Bailey was alive encouraged more and more criticism of his work. As the catalogue of information appeared in the press it became increasingly difficult for the government to put off a thorough investigation into the whole episode. The years of haphazard and half-hearted ‘full investigations’ had continued up until 19 August 1985, when a police task force was established. The New South Wales Cabinet had rejected a recommendation from the Minister for Health, Ron Mulock, that a royal com­ mission be set up. Mulock had obtained advice from legal experts outside the public service. The advice he received confirmed his worst fears: In view of the fact that investigations have already been conducted unsuccessfully into alleged malpractice at Chelmsford Private Hospital, it would appear essential to establish an enquiry with the widest possible investigative powers. Notwithstanding the establishment of the Com: plaints Unit and the proposed amendments to the relevant legislation, [the inquiry] is essential to maintain public con­ fidence in both the public and private hospital systems. Cabinet’s answer to this recommendation was the creation of the police task force. The objectives of the four-member force, headed by Detective Senior Inspector Gordon Campbell, were to investigate the number of deaths linked to Deep Sleep Therapy at Chelmsford, coupled with a request that they examine the possibility of instituting criminal charges against those concerned. They were to direct their investigations toward the possible offences of murder, man­ slaughter and forgery. The task force was given three weeks to complete its assignment. In light of what Campbell called at the Chelmsford Royal Commission the ‘ridiculous’ time limit imposed upon him and the minute staff provided for the job, the inspector assumed that he was carrying out a ‘public relations’ exercise. He further understood that it was his role to ‘close down this embarrassing problem’. The Campbell task force concluded that there had been 20 ‘Deep Sleep’ deaths at Chelmsford. He further concluded

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that there was no evidence that would ‘substantiate a criminal charge being preferred’ against anyone involved with the hos­ pital. He added that any future inquiry under similar terms to those under which they were functioning would be equally unproductive. Campbell also said: What I was getting at there was that it was useless having another inquiry of that nature, bearing in mind the time limitations and investigating so many deaths over such a long period in such a short time. It could not be done. Following Bailey’s death it was decided that a second task force was needed. This time it was given two months to complete its role, and was set up on 17 October 1985. It was to examine all the ‘Chelmsford’ documents held by the Health Department, the Attorney General’s Department, and the judiciary. It was to examine all relevant medical records, inter­ view ex-patients, nurses and other potential witnesses. In com­ pliance with its mandate it executed a search warrant on Chelmsford Hospital. An earlier warrant had been executed on the hospital, but had been found to be defective, and, on an application by Dr Gill, all records were returned. When the later search was carried out, however, there were no records to be found. Three years later, after the establishment of the Royal Commission, a further summons was issued and Dr Gill handed over all the records which had been stored in a warehouse he owned at Newcastle, a city north of Sydney. The second task force completed its work in February 1986, and, as did its predecessor, found no evidence to substantiate criminal charges against Dr Gardiner, but ‘as far as Dr Herron is concerned, the only matter in which sufficient material is available is that of the patient called Audrey Francis’. The final report of the task force recommended that all material relating to the death of John Adams and Audrey Francis should be passed on to the Attorney General for a final decision about any prosecution. On August 27, the coronial unit received an order from the Attorney General directing them to reopen an inquest into the death of Audrey Francis. Miss Francis, a former Sydney journalist, had died in 1976 at the age of 66, two days after she had been admitted by Herron to Chelmsford. In the end, though, no prosecutions were insti­ tuted against Herron or Gill in respect of Francis or Adams.

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In March 1986, complaints against Drs Herron, Gardiner and Gill regarding the treatment of Miriam Podio, and com­ plaints against Dr Gill regarding his treatment of John Adams, and against Herron regarding his treatment of Hart, were referred to the Medical Disciplinary Tribunal. Herron and Gill challenged the right of the tribunal to hear the complaint on the ground that the authorities, as well as Hart and Eastgate, had taken so long to institute their actions that it was an abuse of process for them to continue. The New South Wales Court of Appeal upheld this claim and a permanent stay was ordered. An appeal by the Health Department was rejected by the High Court of Australia. In October 1986, Pat Rogan MP convened a meeting of about 54 former Chelmsford patients, their relatives and friends. He had made contact with these people through the organisation, Chelmsford Survivors. The meeting decided that a new organisation should be formed called the Chelmsford Victims Action Group, whose primary aim would be to cam­ paign for a full inquiry into Chelmsford. In August 1986 a new inquest into the death of Audrey Francis was announced. Mr Greg Glass was appointed to be the coroner. The inquest concluded on 30 June 1988, and Mr Glass found: Audrey Francis died on 14 March 1976 at Chelmsford Pri­ vate Hospital Pennant Hills. I further find that she died from pulmonary oedema following cardio-respiratory failure due to the barbiturate intoxication administered to her in the course of Deep Sleep Therapy at the hospital between 12 and 14 March 1976. During the parliamentary debates which raged about Chelmsford throughout 1987, the opposition spokesperson for health, Mr Peter Collins, castigated the government for its failure to act effectively in the Chelmsford saga. Some people were under the impression that, if elected to government, he would open a Royal Commission into the whole affair. The New South Wales state election in March 1988 resulted in a change of government, but when asked about a Royal Commission, Mr Collins, now Minister for Health, replied that he thought an investigation into the provision of mental health services would be sufficient. Pressure on the

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government to hold a Royal Commission mounted, especially after a series of extremely detailed articles appeared in the Sydney Morning Herald. Written by journalists, Robert Haupt and John O’Neill, they attracted nationwide attention. Edi­ torial comment in all aspects of the media also called for the Royal Commission. On 16 August 1988, 24 years after the death of the first ‘Deep Sleep’ patient at Chelmsford, 24 years after the health authorities had had their first opportunity to stop the treat­ ment after the Xigis inquest, and only after the treatment had led to the deaths of at least 24 patients, and the suicide rate of Deep Sleep patients had become more than twice that of patients who had not received the treatment, a Royal Commis­ sion was announced.

CHAPTER 13

THE ROYAL COMMISSION

The announcement that there was to be a Royal Commission was greeted with joy by the former patients, their relatives and friends, who had joined forces to establish the Action Group. It seemed that at long last they would have an opportunity to tell their respective stories about their experiences at the hands of the Chelmsford doctors. This joy was in contrast to the reaction of practically everybody else who had at any stage been involved with Bailey. Even in advance of any large scale investigation, a great deal of information about Bailey’s work, and about that of others involved with Chelmsford and Deep Sleep, was already on the public record; any further investigation could only worsen their situation. Any formal hearing of the nature of a Royal Commission would no doubt republicise those activities that had been the subject of the original complaint. Expert testi­ mony had already been received which condemned the quality of care given to Podio, Francis, Hart, Vaughan and Coralie Walker. Whatever the cause, there was no doubt that the health authorities had procrastinated and shown little enthusi­ asm for a long-term detailed inquiry that may have, in the end, forced them to prosecute a well-known member of the medi­ cal profession. Again, Bailey’s medical colleagues had also shown little interest in pursuing any of the doctors involved, and any formal hearing would demonstrate this. The nursing staff and the hospital owners, too, had reason to regard the forthcoming hearing with some trepidation. The purpose of the Commission was to examine the pro­ vision of Deep Sleep Therapy and the administration of Chelmsford Private Hospital. It was also to investigate whether or not any person, or any government department, had failed to take appropriate action, or had hindered the taking of appropriate action. As the Commission opened it was apparent that nobody, 163

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except possibly the counsel appointed to assist the Commis­ sioner, Brian Donovan QC, and the perpetrators, had any real idea of the magnitude of the material to be examined. It is customary for a Commissioner to grant to those who ‘have an interest’ in the proceedings a right to appear and be represented by counsel. On the opening day the Commis­ sioner, Acting Justice Jack Slattery, was faced with a parade of counsel, each of whom submitted that they acted for some­ body, or some organisation, entitled to be granted ‘standing’ to appear. The Department of Health and the Attorney General’s Department both briefed counsel; Drs Herron, Gill and Gardiner, as well as patients, nurses, hospital owners, the CCHR, Mrs Bailey, and the College of Psychiatrists, all appeared and requested standing. The Commissioner’s first decision therefore involved who would have the right to appear and be represented. The enormous parade of lawyers seeking leave to appear raised the prospect of the Commission hearings being extended far beyond their allotted time. The judge’s initial response was to exclude those whose interests he saw as being co-extensive with that of the Com­ mission. He saw the patients’ desire for a full investigation as being identical to the aims of the whole Commission, and thus initially he rejected their application for separate represen­ tation, although he did leave open the opportunity for a fur­ ther application. This created considerable upset. Once again the patients saw themselves being excluded from the decision­ making process, but the following week another application was made on their behalf by their solicitor Brenda Duchen, which was accepted, as was a further application from Drs Herron, Gill and Gardiner. Throughout the hearings those who had been granted standing had the opportunity to crossexamine every witness through their counsel. Over a period of two years the Commission received evi­ dence from 297 witnesses and accepted 522 exhibits. In an attempt to ensure that all former patients had an opportunity to be heard, and letters were sent to every patient who had had Deep Sleep Therapy and whose address could be found. All the doctors involved gave evidence, as did other doctors who were called as experts to assess the treatment and the state of medical knowledge during the Deep Sleep period. Nurses, the owners of Chelmsford, Health Department offic­ ers, police officers, members of parliament, and psychologists,

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were all called to provide information to the Commission. Warrants were issued for the recovery of all documents in any way related to the hospital or Deep Sleep, and, to the surprise of most observers, almost 15 years of patient records were still in existence. Mysteriously, though, records which related to the treatment of some patients who had died, either during their treatment or immediately after it, had disap­ peared. The analysis of all these documents was clearly going to take many months, yet the Commissioner seemed to be under some pressure to start the proceedings as quickly as possible. It was decided that the Commission staff would have time to fully marshal their resources while the patients were giving their evidence, and, for the next three months, over 100 former patients, and their relatives and friends, told of their Chelmsford experiences. The human drama that unfolded is now well documented, but the mass of evidence that was produced enabled two conclusions to be drawn: that the clamour for a hearing, which had reached a crescendo in the previous months, was not the result of some unfounded vendetta against a group of caring doctors who happened to specialise in a controversial area of medicine; and that the half-dozen complaints which had been brought to the attention of the authorities were but a small proportion of the total misery created by Chelmsford. As each patient gave evidence, their medical records, where available, were produced. For the first time these people were able to see precisely what had happened to them, and who had been responsible. They saw that treatment had often been provided which had been specifically rejected by them. They heard how they had been shackled to the beds, that they had been forced to lie in pools of their own urine, that they had contracted pneumonia, that at times they were near death, and that, when needed, Dr Bailey was often nowhere to be found. For many, the production of their medical records, and the evidence of other patients, was proof that it had, in fact, all happened, and was not just some figment of an emotionally disturbed mind. For some, the blinding flashes that they thought they recalled were now explained: they had been given ECT without their knowledge and without anaesthetic, and were only partially sedated at the time. For some former patients the Royal Commission produced a painful dilemma. They were anxious to tell their story, but the

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trauma that went with the telling was extreme. Some of the trauma was reduced by a decision of the Commissioner which enabled patient witnesses to remain anonymous if they so desired. Realising the upset being caused, the patients’ legal team employed a social worker to be at court to render what­ ever assistance she could. There were many moments of high drama. Some patients who had spent years trying to prove that their treatment had been bad, were stunned when they heard that there had been legal opinion given years earlier which would have supported their claims. One patient, who desperately wanted Herron to admit that his original diagnosis of him was wrong, became so frustrated and agitated that he had to be escorted from the court. As with all human stories there were lighter moments, too. One of Bailey’s patients had been sent to Chelmsford because he was unable to have sexual intercourse with his girlfriend. He left the hospital in a confused state with prescribed drugs which gave him a feeling of ‘well-being’. He went to a car dealer and purchased an Aston Martin. When asked by coun­ sel if he could afford this, he replied, ‘Afford it!? I couldn’t even afford to fill it up!’ A surprising and poignant aspect of many of the human stories was the remarkable degree of support and loyalty shown by family members through decades of difficult per­ sonal problems requiring drastic lifestyle changes. The legal representatives of the doctors were faced with a tactical dilemma. Under normal courtroom circumstances the patients or their families would not be able to relate infor­ mation about which they did not have first-hand knowledge, because it is considered by the court to be unreliable. A Royal Commission is different. Witnesses are allowed to give evi­ dence which includes second-hand stories, impressions, non­ expert opinions, and even rumour. In this case, even if a patient was mistaken about the detail, the vast quantity of consistent evidence which was presented to the Commission had the effect of transforming the normally unreliable into the acceptable. Lawyers for the doctors were forced to decide how they would treat the evidence given to the Commission by the patients. They could either allow them all to tell their stories unchallenged and make submissions about them at the end, or

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they could attempt to throw doubt on their credibility one by one. Counsel for Dr Herron and counsel for Dr Gill chose the latter course, whereas counsel for Dr Gardiner chose to remain silent. It was impossible to challenge those facts which were supported by the medical records. Much time was there­ fore spent ascertaining whether or not the witnesses were members of the Chelmsford Victims Action Group, whether they were Scientologists, what their symptoms were prior to visiting any of the doctors, and what their medical history had been after the treatment they had received from Bailey, Herron or Gardiner. Commenting on this the Commissioner stated: While cross-examining a number of Chelmsford Victims Action Group former patients, counsel for Dr Herron implied they were party to a conspiracy in giving their evidence to the Commission. They were questioned about their attendance at group meetings and discussions about events and treatment at Chelmsford. However, counsel for Dr Herron, Dr Gardiner and Dr Gill did not make such a suggestion in their closing addresses. I am satisfied there was no agreement among Chelmsford Victims Action Group members to give false or exaggerated evidence to the Commission. It had originally been proposed that the nursing staff would give their evidence after the patients, but this was changed when Dr Herron decided he was not prepared to make a written statement. As a result of this decision he was called to give his evidence immediately. Herron’s position was clear: He had been seduced by Bailey; Bailey lived in a dream world and the treatment did not result in the coma that Bailey claimed was necessary; his [Herron’s] patients received different treat­ ment from Bailey’s; the hospital was adequately equipped to provide the necessary back-up support for the treatment; the nursing staff was sufficiently skilled to make the judgements about the prescription of medicine; he knew little or nothing about the deaths; he could see nothing wrong with the treat­ ment. Those who gave evidence often had a poor recollection of events. Molly Sansom, long-time secretary at Chelmsford, was unable to recall sending documents about the first instance of

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litigation to the hospital’s insurers. Sandra Robson, who was matron between 1971 and 1976, only recalled one of the nine deaths that occurred at Chelmsford while she was there. Despite the evidence, most witnesses who were associated with the hospital were still unable to remember the events. In the end, the Commissioner found that Bailey’s ‘role was central. Without him there would have been no Deep Sleep’. The Commissioner also stated that, He was two-faced, devious, dissembling and unprincipled; subject to severe mood swings. Dr Bailey told most serious lies at times. He has been described by some people as utterly mad, quite amoral with a complete lack of know­ ledge about right and wrong. He had a tendency to be flamboyant, to exaggerate, to shock, to drive home points by shocking. Acting Justice Slattery also went on to comment that In assessing him it is difficult not to be influenced by his most disgraceful conduct with some female patients, par­ ticularly as these were emotionally distressed people .. . Considering the dependence some of them developed on him, it is difficult to imagine more destructive behaviour or a more distressing situation for these patients. Bailey’s whole lifestyle, personal and professional, depended on support from people who would at best give him assistance or at least would not interfere. One was Dr John Herron, whom the Commissioner found ‘came under the spell of his mentor Dr Bailey’? He also found that Dr Herron’s attempt to play down his contributions to the Chelmsford tragedy over 16 years to a mere error of judge­ ment is completely unacceptable. He must have been aware of the catalogue of disasters which began in 1964 and con­ tinued even after the doctors’ meeting of November 1978 at which he continued to be an advocate of DST. Commissioner Slattery also stated that Herron was manipulative both as a witness and as a person. On

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many occasions he attempted to draw sympathy to his pos­ ition by expressions of pathos which I have grave doubts he felt. My impression is that he embarked on a deliberate campaign to conceal as much as he could from the Royal Commission while at the same time attempting to paint a picture of a pathetic and wronged man. He was not so. It was shown that when Herron found that he did not have sufficient time to carry out all the ECT that Bailey had ordered, he also needed a substitute. Dr Ian Gardiner was prepared to visit the hospital three or four times a week on the way to his regular work. Commissioner Slattery found that Gardiner ‘believed he had nothing to do with DST despite the evidence to the contrary. It was only after a thorough examination of documents that he was constrained to admit that he was the treating doctor for a number of patients.’ And, He was more than the ECT man, a functionary without professional involvement in DST. He was part of the treat­ ing team at Chelmsford. He has avoided providing information and cooperated in presenting a “united front” with Dr Bailey when their interests were at variance. He neglected patients ... He followed on quietly behind his confreres knowing standards of treatment at Chelmsford had dropped. He did nothing. In order for Bailey to offer Deep Sleep as a form of therapy he had to find a hospital prepared to allow him to do it. Chelmsford Hospital, one of whose part-owners was Dr Gill, was an ideal place. Gill, found the Commissioner, was a person who was de facto in charge of Chelmsford. Dr Gill was the person who took charge of the campaign against any person who criticised Chelmsford ... If he had been honestly concerned about patients’ welfare, he would have been prepared to discuss the problems at Chelmsford and the records with the officers of Health. He took a deliberately obstructive approach. It is clear to me that he believed he and the hospital were vulnerable to attack for wrongdoings which occurred there. I do not believe that he fought these campaigns purely as a

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matter of principle. I believe that he knew that wrong­ doings had occurred and he used every device that he could to keep the matters concealed. Commissioner Slattery also found that Dr Gill was prepared to rely on any matter which he could to justify what I consider was inappropriate behaviour both in the Commission and at the hospital. He had inappropri­ ate attitudes, inappropriate judgement and gave appalling medical treatment. Dr Gill must bear a large part of the responsibility for the consequences both in terms of the suffering and sometimes deaths of patients, not merely his own, and in terms of the expense of the people of NSW. Bailey visited the hospital only spasmodically, Herron between two and three times per week, and Gardiner spent about half an hour at the hospital three or four times per week. For the rest of the time the unconscious patients were in the hands of the nursing staff. The Commissioner found that ‘nursing care was inadequate, and the patients’ health and welfare were at risk when, as happened at different times, the nursing staff did not follow the doctors’ written instructions on the drug regime’. But he also found that the nurses were put under an unreasonable and intolerable burden by having to virtually run the sedation ward because the doctors involved never regularly visited the hospital. However, they generally carried out their duties well under difficult circum­ stances. Slattery stated that ‘without the efforts of these nurses, the tragedies, the deaths and catastrophes which befell patients at Chelmsford would have been much greater’. And, ‘the terrible tragedy is that Dr Bailey and Dr Herron — who were aware of the monstrous problem which confronted nurses when exer­ cising their judgements in the administration of drugs — allowed the hazardous treatment to continue without any real changes of direct medical supervision ... It was a deplorable situation.’ A private hospital such as Chelmsford cannot operate with­ out a licence. This licence is issued by the Health Department and entitles that Department to inspect the premises and

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administrative medical procedures of the hospital. Commis­ sioner Slattery found that ‘it seems inconceivable that the events which unfolded at Chelmsford over the years would not have been uncovered’, and suggested that ‘the problem perhaps was not a lack of will but a lack of awareness that in a society there are times when action must be taken’. Of the medical profession he said, It is of critical importance that the community realise the strength of the medical lobby. The Chelmsford saga has demonstrated that the profession cannot be relied on to keep its own house in order without some investigative mechanism such as the Complaints Unit, which may involve practitioners seriously departing from proper practice. The Commissioner made specific comments on the issues of patient consent and fraud. About patient consent to treatment he said, The signature on some [consent] forms was obtained by fraud and deceit. Some were signed by people whose judge­ ment was compromised by drugs. Some patients were even woken up from their DST treatment to complete the auth­ orisation. Other patients were treated contrary to their express wishes and some were treated despite the fact they had specifically refused the treatment. And of fraud, Commissioner Slattery found there was ‘no doubt’ that Drs Bailey, Herron and Gardiner were involved in consistently defrauding the Commonwealth and the private health funds by charging for treatments never given and for visits never made. It was impossible to say how much was involved in total, but of the 51 records of Dr Bailey’s patients provided to the Commission, only one showed a correct date and a correct payment. The Commission vindicated all those who had being trying for nearly two decades to bring the abuses of Bailey and his team to the public notice. One of the most disturbing aspects of the Commission’s findings is that Bailey’s abuses at Chelmsford were not the result of some conspiracy. They were facilitated by doctors

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who saw no evil, by nurses who knew no evil, and by the authorities who did nothing. These people did not seek out Bailey or Chelmsford. They were ordinary people doing ordi­ nary jobs. How much their actions were influenced by Bailey is dif­ ficult to deduce, but Commissioner Slattery remarked in his report, ‘It is necessary to try and go behind [his behaviour and reputation] to assess him. Because he is the centre of the whole controversy, there can be no true understanding of it without an understanding of him.’

CHAPTER 14

CONCLUSIONS

Bailey’s high profile and public utterances in the 1950s had a profound effect on the careers of a number of potential medi­ cal graduates at that time. One recalled: At first I had no intention of practising psychiatry. It seemed to me that it was not very scientific and not very successful. Bailey made it sound as though it was on the threshold of something new and exciting and I wanted to be there as well. Another young graduate of that period was Dr John Sydney Smith, who was to become one of the most forthright critics of Bailey and Chelmsford: I remember visiting Callan Park during my residence year. Bailey was the superintendent and he showed us around. We were taken into the public hospital area and it was dreadful, and he took us immediately to see the CSRU. The CSRU was full of high technology and the contrast was stunning. Bailey emphasised this contrast, he pointed to the CSRU and proudly proclaimed, ‘the walls are coming down, the walls are coming down’. He even made those who had been practising psychiatry for many years feel confident about themselves and the future of the profession. They saw that at last they might cease to be regarded as the poor sister of the profession, and many saw Bailey as a bright young ‘Turk’ who would ‘lead us out of the wilderness’. ‘Apart from ECT, which, before the use of muscle relaxants was pretty severe, most of us knew little about ‘inter­ ventionist’ psychiatry. The establishment of the CSRU with a one million pound grant from the government was not only the envy of all other 173

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branches of medicine but it was viewed as official recognition of the future of the psychiatric profession. While the respect his colleagues had for him soon waned, and most now agree that his net effect has been negative, there is no doubt that he had placed the practice of psychiatry firmly in the spotlight. Even though Bailey’s personal image suffered following the Callan Park Royal Commission, the treatment of mental patients and the administration of state mental hospitals had altered forever. The treatment of mental health patients and the legal protections offered to them became a topic of aca­ demic discussion and research. Australia joined the world­ wide debate about the respective roles of administrators, doctors, lawyers and families in the ultimate determination of an individual’s mental health and subsequent involuntary com­ mittal to an institution. Until this time, mental health issues were considered to be in no way different from other medical matters, and therefore best left to doctors. Little thought was given to the denial of civil rights which followed involuntary committal to these institutions. It was the revelations of the conditions under which inmates of mental institutions were forced to exist which excited the emotions of the public and created fertile ground for a more fundamental analysis of the whole area of public mental health. Over the objections of psychiatrists, mental health is now firmly in the public forum and subject to scrutiny not applied to other branches of medi­ cine. Although some of the changes were slow in arriving and some continue to arrive, mental institutions are no longer hidden away from the public eye, and patient conditions are constantly improving. Some psychiatrists have said that ‘the walls were coming down’ all over the world, and that Bailey merely accelerated their destruction. Whether he was the originating cause or whether he only hastened its progress is a matter of specu­ lation, but as a result of the Callan Park inquiry psychiatry in Australia would never be the same again. Not only was Bailey the first Australian to be the prime cause of two Royal Commissions, but were he alive today he would be able to identify many sections of current New South Wales legislation which reflect medical, communal and gov­ ernmental responses to his actions as a psychiatrist. The Mental Health Act stipulates that psychosurgery can

CONCLUSIONS

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now only be carried out following a hearing before a specially constituted tribunal and at an approved hospital. Electroconvulsive therapy also requires a hearing and can only be given if the members of the Mental Health Review Tribunal are satisfied that no other possible treatment can reasonably be used. Deep Sleep Therapy is banned. Private hospitals which primarily provide psychiatric treat­ ment must be specifically licensed. Provision for emergency medical services must be available on the premises to the patients. The licensee of a psychiatric hospital must appoint a medical practitioner as the medical superintendent, who must ensure that records are kept which detail ‘the admission, treat­ ment, discharge, removal, absence with or without leave, or death of each patient admitted to the hospital’. These records must be sent to the relevant authority, at unspecified regular intervals. The 1980s saw changes in community attitudes toward the practice of medicine. Much of this change was spurred on by the constant publicity relating to Chelmsford and the failure of the profession to adequately regulate itself and protect the vulnerable public. The publicity given to such people as Hart, following their successful actions against doctors, prompted others, who previously would have remained silent, to ques­ tion the necessity of a bad medical result. Fear of the legal consequences of these patient grievances prompted a change of Articles of Association of the New South Wales Medical Defence Union. While this made sound commercial sense in the case of Harry Bailey it has, at the time of writing, left an unknown number of patients who have suffered at his hands without the possibility of compensation. It may well be thought that the collective guilt of the profession would have prevented this happening. Even so, the annual premiums doc­ tors pay for whatever protection they are now able to obtain, has risen from $100 per year in 1980 to up to $10,000 in 1990. In an attempt to head off long and expensive litigation, as well as to identify problem areas, the New South Wales Medi­ cal Complaints Unit was created. Its workload is increasing yearly as the public begins to realise that genuine complaints should be investigated, even if no litigation follows. The increase in medical litigation throughout the whole of Australia has forced the courts to look again at some long-held

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principles. In 1980 a court would rule a doctor not negligent provided it could be shown that a body of medical opinion, even that of a very small minority, approved of the actions under challenge. By 1990 the situation had changed. The courts have at long last asserted themselves and, at least in New South Wales and South Australia, the appropriate stan­ dard of medical care is no longer measured by reference to what is current practice, but rather, by what it ought to be. Ethics committees and peer review are now commonplace, and the ability of the New South Wales Medical Board to discipline doctors who have been found to be negligent is of post-Chelmsford origin. While it is relatively easy to identify consequences, causes remain elusive. ‘Bailey rumours’ existed throughout his whole professional career. These rumours centred around his strange personal behaviour as well as his odd medical practice. The medical ethic which prompted a number of psychiatrists to walk past the Deep Sleep ward day after day and not query the obviously unusual treatment being used there must surely be questioned. If this failure to inquire about a psychiatric treat­ ment of unknown nature and unknown merit was caused by a lack of intellectual curiosity, then medical education itself must be examined. Bailey’s clever use of language highlighted the community’s vulnerability to its misuse. Had he practised ‘coma treatment’ instead of ‘Deep Sleep Therapy’, his activities would have been challenged almost before he started. ‘Therapy’ gave the procedure an air of respectability and mildness and, after all, what could be more beneficial than a good sleep? Even taking into account the subordinate role of the nurses during the Bailey era, the reasons for their almost blind accep­ tance of the treatment, which resulted in so many deaths, remains a mystery. Two thousand five hundred years ago the Persian king Darius ordered the killing of the messenger who brought him the news that his army had been defeated by the Greeks at the battle of Marathon. Over the centuries, authorities have often been content to follow his examples and reject any unwanted or uncomfortable information, especially when it has been provided to them by an unpopular or discredited individual or group. The blinkered vision which prompted authorities to ignore information about death and damage because it was

CONCLUSIONS

177

provided to them by a branch of the Church of Scientology, must be challenged. The fact that Bailey’s sexual activities with his patients cre­ ated salacious interest, rather than abhorrence and indigna­ tion, reveals as much about those who knew but didn’t act, as it does about the actor himself. The fierce loyalty shown to Bailey by his mistresses, in the face of hurt and insult, may cause some surprise, but the fact itself is not unusual. Bailey’s reputation for brilliance, based, as it has shown to be, on a total absence of substance and his own repetition of the fact, was maintained simply because nobody bothered to check. The doubters were thought to be unreasonable and motivated by jealousy. The justification of any actions which result in the callous treatment of human beings, no matter how different, difficult or annoying they may be, must not be allowed. The way in which daily routine, and the force of Bailey’s personality, changed the exotic and fatal into the accepted and ordinary, must surely sound a warning to society at large. History shows us that blind acceptance of authority inevitably brings with it horrendous consequences, and in this regard Bailey and Chelmsford were but a microcosm of many larger and more brutal events. The character of Bailey himself remains a complex mixture of apparently competing motivations and forces. His early days at least were full of professional promise. He was a tireless worker and, if his original reason for entering the psychiatric practice of medicine was indeed because he was in search of a nine-to-five job, he soon changed his mind. Even if his push for the establishment of the CSRU was mainly for self­ aggrandisement, he nevertheless put together a group of researchers and a collection of equipment that was the envy of the international medical world. Some of the equipment he had purchased for the CSRU is still in operation over 30 years later. The history of scientific discovery is strewn with hypotheses which have been tried, found wanting, and discarded. Although Bailey’s ideas were not absolutely original, his exten­ sion of the concept of insulin coma therapy and his search for the part of the brain that was responsible for various psychi­ atric problems took him well beyond the intellectual scope of the average psychiatrist. While his enquiring mind took him

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into areas unknown to the general profession, his inability to discipline himself to carry out systematic and careful research, and his inability to accept the fact that an initial hypothesis may eventually turn out to be incorrect, prevented him from turning back from any chosen path. His flamboyant behaviour caused a rift with other doctors and, as time went by, he became increasingly isolated. It became emotionally impossible for Bailey to seek advice from those colleagues he could have and should have consulted before his venture into Deep Sleep Therapy began. While it is true that regulations are often introduced to protect consumers, it is also true that these same regulations often protect the providers from themselves. It is easy to identify the failure of the medical regulatory system as a major cause of the horrors that occurred at Chelmsford, but that same failure had the effect of allowing a potential medical pioneer to die in disgrace. Had those who appointed Bailey to the position of head of the CSRU looked for substance rather than form it is unlikely that they would have chosen Bailey, who would then have been forced to re-evaluate his career plans. There is no doubt that Bailey revelled in the public lime­ light, and while to some extent this may have been the moti­ vation behind his expose of Callan Park, it was the inaction of the relevant authorities to deal with the problems of adequate mental health care that induced him to bring his complaint to the public. Although he was at that stage highly regarded, not even he could control the powerful forces that operated once the row had entered into the public forum. Had the whole matter been internally investigated, as Bailey had intended, his exaggerations would not have been made the subject of politi­ cal debate and emphasis placed on errors, rather than the general thrust of his claims. The public humiliation which the Callan Park affair caused Bailey resulted in bitterness towards those in control of the administration of psychiatric services. Because he saw himself as the victim of political intrigue his self-esteem remained unbruised. In spite of all the criticism that plagued him for the next 23 years he continued to see himself as unjustly maligned. He protested to those close to him about the appar­ ent vendetta being waged against him by the Scientologists, but he refused to examine himself to ascertain whether or not

CONCLUSIONS

179

he was fuelling their campaign. As allegations against him grew, he responded by making more and more outlandish claims. It does not seem to have crossed his mind that his claim to the Chelmsford nurses that he had carried out five million hours of Deep Sleep meant that he must have treated approximately 20,000 patients, more than ten times the actual number. It also doesn’t seem to have crossed his mind that the information he disclosed to his professional colleagues in his circular of 1982, if checked, would have been shown to have been untrue. He may, of course, have been relying on the fact that for almost his entire professional life nobody had ever bothered to examine in any detail the substance of his asser­ tions. He apparently never considered the possibility that those he had treated so badly would think ill of him, or not come to his aid in his hour of need. That they did, only reinforced this belief. The contrast between appearance and reality in so many of Bailey’s actions makes it difficult to find his credo. He know­ ingly made himself persona non grata with the mental health establishment by attacking their neglect of public mental patients, yet within one year of private practice, he was guilty of the same neglect. He set out to establish himself as a respected medical researcher, yet at no time did he follow even the most elementary principles of scientific experimentation. In his early days he seemed to court publicity actively, yet he refused to participate in public debates about psychosurgery, either in Australia or overseas, an area in which he considered himself an expert. His interest in art, music, craft and litera­ ture was genuine, yet he often behaved like an uneducated lout. He attracted around him a group of friends who even in the face of universal condemnation of his behaviour remained loyal and non-judgemental, even though he didn’t reciprocate. His refusal to write a reference for Jan Allan when she left his employment shows incredible pettiness and a lack of gratitude. He didn’t hestitate to turn to her when he needed help, certain she would give it. As she did. He built for himself a reputation as a superb expert witness, after-dinner speaker and an entertaining presenter of papers at conferences, yet his only recorded speech, some of which has been reproduced in chapter 10 in an edited version, is an almost inarticulate ramble.

180

DEEP SLEEP

His public reputation as a brilliant if eccentric doctor lasted almost until the opening of the Chelmsford Royal Commis­ sion, yet the origins of this reputation are impossible to find. Jan Allan still speaks of Bailey’s concern for his patients and his sorrow when one of them died, yet he pushed ahead with his treatment when there was absolutely no reason why he could not have terminated it at any stage. He railed against the use of illicit drugs and their effect on society, yet he distribu­ ted drugs of addiction to his patients from his surgery without keeping adequate records, and established a form of treatment which had as its cornerstone doses of addictive drugs. To some he was a handsome charmer, yet to others he was an arrogant, foul-mouthed egoist. Jan Allan tells of his criticism of the moral direction of society, yet he had no hesitation in system­ atically defrauding the community by charging for services he didn’t provide. He attracted women with apparent ease, treated them abominably, made no effort to hide his infidelity, yet maintained both a seemingly endless supply of lovers and the loyalty of his cast-offs. He dreamt about building a hospital entirely to his own specifications, yet he took only half­ hearted steps to complete the project even though he had the means to do so. The hospital remained a mere building shell and never admitted one patient, yet he felt compelled to call himself its medical director and fraudulently obtain a licence for its operation. It may well be that the contradictions were the reality. It may well be that Bailey was a person driven by inner forces he could not control and was forced into a corner from which there was no escape. It may well be that his character was fundamentally flawed and the tragedy was the failure of the system to identify the flaw. But a greater tragedy was the damage and misery he caused others. If society is responsible for Bailey’s abuse of power it must also be responsible for the pain he ultimately caused, and must ensure that such a sorry saga can never be repeated.

INDEX

Adams, John, 114, 160, 161 Allan, Jan, 60-1, 64, 67, 69, 71, 73-8, 80, 106, 110, 139, 141, 152-4, 156-7, 159, 179, 180 Askin, Mr Robert, 33

Cameron, Dr Ewan, 10-11 Campbell, Detective Senior Inspector, 159-60 Carter, Mr Graeme, 63-4, 81, 84 Central Intelligence Agency (CIA), 9, 10,

Bailey, Dr Harry Richard Callan Park, see Callan Park Psychiatric Hospital charges laid against, 145-53 Chelmsford, see Chelmsford Private Hospital coronial enquiries, 62-4 CSRU, see Cerebral Surgery Research Unit deaths of patients, 60-3, 93, 109-10, 111, 114, 116, 118, 142, 143, 145, 146 148, 162, 168 Deep Sleep, see Deep Sleep Therapy drug dispensing and prescription, 81-7, 142, early life, 1-13 education, 2-3 exclusion from Chelmsford, 139, 144 lecture on Deep Sleep, 123-38 Mandala, 65, 67, 72, 83-4, 121, 139 Medical Superintendent, Callan Park, 22-34 obituary, 154 police investigation, 148 private practice, 35-41, 56 Psychosurgery, see psychosurgery publications, 52, 87-8, 89, return to Australia, 14-22 St Annes’ Private Hospital, 39-41 sexual involvement with patients, 67-80, 168, 177 suicide, 1, 153 training at Broughton Hall, 6 WHO, travel grant, 7-13 Bailey, Mrs Marjorie, 2, 4, 32, 34, 36, 48, 57, 60, 67, 78, 80, 110, 152, 154, 164 Barker, Mr Ian, QC, 146 Bick, Gordon, 90, 91 Black, Dr Jules, 35, 36, 44, 58-9 Boettcher, Dr Brian, 116-19 Brain surgery, 9, 10, 12, 19, 38, 39, 52, 57, 90, 99 Broughton Hall, 3, 6, 7, 12, 20, 124, 155

Cerebral Surgery Research Unit (CSRU), 16-22, 25, 34, 38, 42, 45, 49-50, 52-4, 89, 155, 173, 177-8 Chelmsford Private Hospital, 10, 12, 41, 42-55, 60-5, 70, 81-4, 89, 92, 93-7, 100-119, 121-5, 139, 144-5, 148, 150, 159, 161-2, 163-72 Chelmsford Royal Commission, 4, 20, 32, 34, 48-50, 58, 60, 62-4, 67-8, 79-80, 83, 87-8, 97, 101, 141, 145, 150, 159, 161-2, 163-72, 180 Chelmsford Survivors, 151, 161 Chelmsford Victims Action Group, 161, 163, 167 Church, Mrs Audrey, 39, 40, 54 Citizen’s Committee on Human Rights (CCHR), 111-2, 113-5, 116, 142-3, 147, 164 Collins, Mr Peter (NSW Minister for Health), 161 Coma therapy, 42-3 Coroner’s Act, 61, 146, 147 Crown Street Women’s Hospital, 60, 68, 73, 155

Cahill, J. J. (NSW Premier), 18 Callan Park Psychiatric Hospital, 5, 22, 23-38, 45, 55, 61, 89, 100, 156, 173, 178 Callan Park Royal Commission, 29-30, 32-3, 37, 139, 156, 174

11

Dash, Mr Robert, 51, 65, 83 Davies, Evan, 3, 18, 36, 43, 53, 54, 78, 87, 91, 153, 154 Deep Sleep Therapy, 43-55, 56, 59-65, 70, 78-9, 81, 92-7, 99-119, 121-38, 141, 144-6, 150, 158-9, 161-2, 163-72, 175, 177-9 Dinnervale, Doug, 77-8 Division of Mental Hygiene, NSW Department of Health, 7, 16 Donovan, Brian, QC, 164 Dowling, Dr John, 18, 38-9, 52-4, 90 Duchen, Brenda, 164 Eastgate, Jan, 115, 147-8, 161 Echardt, Frederick, 62 Edwards, Matron Beverley, 62, 93 Electroconvulsive therapy (ECT), 6, 8, 10, 21-2, 43, 47, 49, 52, 54, 79, 80, 92, 102, 112, 116, 128, 134-5, 148, 150, 165, 169, 173, 174 Electronarcosis therapy, 8 Ellard, Dr John, 88 Fawdry, Matron Marcia, 72, 74, 79, 80, 95, 106-7, 116, 122

181

DEEP SLEEP

182 Forbes, Mr Terry (Coroner), 144 ‘Four Corners’ programme (ABC), 90, 91 Francis, Audrey, 160, 161, 163 Fraser, Dr Ian, 7, 16, 28, 29, 33 Gardiner, Dr Ian Donald Ross, 21, 92, 119, 144, 145, 150, 151, 160, 161, 164, 167, 169 Gibson, Dr, 155 Gill, Dr John Ewan McDonald, 72, 92-3, 97, 113, 119, 160, 161, 164, 167-70 Gillard, Mrs Daisy, 75-6, 77 Gladesville Mental Hospital, 24, 90 Glass, Mr Greg (Coroner), 161 Glissando, 21-2 Goldrick, Mr J. B. (Coroner), 77 Greenaway, Dr John, 3, 4 Hamilton, Sharon, 69-77, 113, 115, 139, 141 Hand, Mr Derrick, 147 Hart, Barry, 107-9, 112, 140-43, 146, 149, 150, 151, 161, 163, 175 Hart v. Herron, 145, 150 Hatton, Mr John (MP), 148 Haupt, Robert, 162 Heath, Robert G., 9, 10 Hefferon, Mr John (Premier), 29 Herron, Dr John, 3, 5, 12, 18, 20, 37, 49, 52-4, 57, 66, 78-9, 84-7, 92, 97, 102, 107-9, 112, 116-7, 118, 119, 121, 140, 141, 143-6, 151, 160, 161, 164, 165, 167, 168-70 Holland, Dr Ross Beresford, 146 Hooke, Sir Lionel, 22 Hornsby District Hospital, 108, 109, 114, 116, 117, 150 Howard, Matron Elva, 41, 53 Insulin coma therapy, 6, 12, 124-5, 177 Irvine, Dr Frank, 18 Joseph, Professor Maurice, 46, 49, 79 Kell, Muriel, 60, 62 Kiloh, Professor Les, 89 Kingston, Kelvin, 62 Lamond, Toni, 105 Larwood, Miss Patricia, 82 Leksell, Professor Lars, 12, 155 Leucotomy, 88, 90 Limb, Bobby, 105 McClemens, Mr Justice, 29, 30, 156 McGill University (Montreal Canada), 10, 155 MacArthur, Helen, 139-40, 146, 149, 151-4, 156-8 Maddison, Professor David, 5, 20, 90 Mandala, 65, 67, 77, 83-4, 121, 139 Medical Complaints Department (NSW Health Department), 149, 150, 159, 171, 175 Medical Defence Union of NSW, 149, 150, 175 Medical Disciplinary Tribunal, 161 Mental Health Act, 174 Mental Health Review Tribunal, 175 Minecta, 21, 22, 80

Morson, Dr Stuart, 18 Mulhearn, Dr Richard, 16, 34, 36 Mulock, Ron (NSW Minister for Health), 159 Myers, Jill, 57-8 Nash, Len (Coroner), 64 NSW Medical Board’s Investigating Committee, 147, 148 Nicholson, Rosa, 12, 110-15, 121, 123, 142, 145 North Ryde Psychiatric Hospital, 92, 118,

121 NSW Health Commission, 110-11 NSW Nurses’ Association, 110 O’Neill, John, 162 Ortado, Leo, 101 Podio, Miriam, 99, 113, 142-3, 145-7, 149, 161, 163 Prince Henry Hospital, 39, 52, 90 Psychosurgery, 43, 52-3, 59, 87-8, 90, 91, 136, 174 Public Service Board, report, 25-7 Ray, Matron Clare, 39-41, 48 Robson, Matron Sandra, 78, 168 Rogan, Mr Pat (MP), 148 Rogers, Mary, 62 Roth, Sir Martin, 112, 143 St Anne’s Private Hospital, 39-41, 42, 48, 57, 121 St Clair, Arnold, 110-1 St John, Mr Edward, QC, 143 St Vincent’s Hospital, 146 Sackar, John, QC, 150 Sansom, Molly, 167 Sargant, Dr William, 11-12, 39, 42, 45, 47, 151-3, 155 Sedation therapy, 10, 11 , 39-41, 42 Segal, Ron, 111-3, 115 Shea, Betty, 41, 42, 121-2, 124, 129 Sheahan, Mr Billy (NSW Minister of Health), 29, 30, 32-4 ‘60 Minutes’ (TV programme), 142-4 Slattery, Acting Justice Jack, 164, 169-72 Smith Dr John Sydney, 18, 20, 53, 89, 90, 112, 143, 173 Smith, Matron Julie, 72, 95-6, 97, 111,

122 Swanton, Dr Cedric, 5, 57 Thorpe, Professor, R. H., 64 Trethowan, Professor Paul, 5, 21 Vaughan, Patricia, 150-53, 158, 163 Wade, Professor Dennis, 146 Walker, Coralie, 119, 163 Walker, Frank, (NSW Attorney General), 115, 143 Walton, Merilyn, 149 Williams, Dr S. E., 89, 90 World Health Organisation (WHO), 7-10 Wran, Neville (NSW Premier), 143 Wright, Stevie, 102-3 Wurth, Mr Wallace, 27 Xigis, Antonios, 60, 62