Visitors’ Lounge

Finola Scott

Visitors’ Lounge

Audience more like
May the circle be unbroken
We take our seats as you direct.
Hands origami  on laps we
listen try
to work out  new parts Try
not to stare at the parcel
that is  you in here unkempt hair
crumpled trousers plaid slippers
Lord, by and by
We echo your breath  don’t
dare disagree  introduce fresh patterns
we exercise
caution following
always following  There’s a better home
awaiting in the sky, Lord
We try to be patient.

Blitzkreig

shocking & I’m shocked
dancing frogs legs  Jane Austen
cavorting in Bath
gym-slipped Madame Curies
we tell ourselves
it’s Science  modern important

shocked that we don’t talk
you travel out  the cheery blossomed way
lie down grateful  for this blessing
I don’t ask   question your peace
subject off limits
shocked

Ponders End

1
The Edison Swan Electrical Co
shock therapy
apparatus  serial No. 12257/7
supply the new type
of headbands and electrodes
return  the old harness
yours faithfully
Senior Assistant Physician

2
convulsions
shock voltages
up to 150 volts current
up to 500 mA
Advantages     low cost  portability
robustness  ease of operation
freedom from risk
of accidental shock

3
treatment under a cloud
two        distressing     accidents
both femurs
fractured
over   50 years     of age
appalling
failed          to diagnose         deluded
this can occur          this
particular                 treatment

strike a swift, focused blow at an enemy using mobile, manoeuverable forces,
an attack ideally leads to a quick victory, limiting the loss a lightening war

A        blitzkrieg      is a     fast       and       intense         military attack that takes
the          enemy       by      surprise
and is          intended        to      achieve      a very         quick      victory.
the ‘concentration principle,’ the idea that concentrating forces against an enemy, and making a

single blow against a carefully chosen target (the Schwerpunkt, or ‘centre of gravity’) was more

effective than dispersing those forces.

Commentary

The information about the former residents/patients of the hospital that Gillean McDougall supplied to participants in Writing the Asylum was compulsive. As I still remember the disturbing experience of going with a friend in the late 60s to visit his sister in Gartnavel who was suffering from profound postnatal depression, the project had a personal dimension.

I was shocked to read that my friend’s sister was not alone. According to a research paper published by St Andrew’s University, ‘Some 150,000 people resided in UK asylums in 1954, a rate per head of population nearly 7 times greater than 1800. At that date half of all NHS hospital beds were given over to patients with mental illness or impairment.

However as this project started, my life became complicated – 6 bereavements of friends in 4 months. On top of this the purchase of new home fell through 2 weeks before my planned move. I sat surrounded with boxes I had packed returning from funeral after funeral. So selfishly, I couldn’t face examining the difficulties of individual patients’ lives.

Instead I turned to other memories and family stories. I remembered that a relative had been a patient attending Gartnavel. I didn’t know why, except that ECT was part of the treatment. This had always interested me as for a while it had been a controversial treatment. However although I remember my relative being happy to attend the hospital and happy to repeat the treatment the whole thing was treated not only as private but as a secret even within the close family.

The Wellcome Trust allowed me access to fascinating documents which are not available in the public domain via the website – ranging from articles in professional journals as well as correspondence between staff at the hospital and the firm supplying the ECT equipment. By co-incidence I was chatting in a group with a poet friend who asked what I was working on. When I mentioned the ECT, one of the people in the group cheerfully told us that his father had received this treatment. He went on to outline the improvement in his father’s moods. I was fascinated by the openness of this in contrast with the secrecy surrounding my family situation.

Another co-incidence was learning about conditions in asylums when reading The Silent Weaver by Roger Hutchinson. This book told of Angus MacPhee who spent most of his adult life in institutions after the Second World War. Various treatments used at the time were examined including ECT. The author shared a view I had read elsewhere – that the film One flew over the Cuckoo’s Nest was in part responsible for the current negative attitude to this treatment.

It seems that the jerking spasms which led to patients breaking bones had occurred in early administration of ECT. It had been observed that after seizures, epileptics appeared to be relieved of psychotic symptoms. Drugs were then used to induce similar seizures. Wanting to replicate this effect without the use of drugs doctors turned to ECT. Ironically it was the restraints, used to attempt to protect the patient from harm resulting from uncontrolled jerking, that resulted in injury. Later this dreadful situation was avoided when patients were sedated before receiving the carefully measured current. Unfortunately letters to the Swan Electric Company from doctors at Gartnavel reveal that patients’ broken limbs had not been diagnosed immediately. No wonder ECT had a bad reputation. However I gathered the impression that it helps with a range of conditions including treatment resistant cases of depression and in some cases of bipolar affective disorder and schizophrenia.

This extract from a research document included in the Wellcome papers seems to support that idea: ‘Clozapine-resistant schizophrenia remains a major challenge in the practice of psychiatry with limited evidence-based intervention.’ (Remington et al., 2017). Most people with this condition, the majority of whom are relatively young, lead their lives with substantial subjective distress and disability. Electroconvulsive therapy (ECT) is sometimes recommended by clinical practice guidelines (Kane et al., 2019;Taylor et al., 2021) and is commonly prescribed for this condition.

However it is worrying to read: ‘In the context of poor-quality evidence supporting the use of ECT in treatment resistant schizophrenia, the report of the Royal Claims for the efficacy of ECT in treatment-resistant schizophrenia would perhaps best be described as a triumph of anecdote over empiricism (Scott, 2005). Despite this scepticism, treatment resistance is one of the commonest indications for ECT in schizophrenia across the world (Pompili et al., 2013; Phutane et al., 2011). Thus, ECT is commonly prescribed worldwide for an indication with inadequate evidence.’

It was odd to see that the Swan Electric Company supplied much of the equipment. This jarred as I remember that the electric kettle in my childhood home was supplied by Swan. I felt a gap between the purpose of these electrical implements.

Walking the grounds of the hospital was confusing. On the surface it was pleasant to think of past patients happily working, growing vegetables and herbs. It was too easy on a bright day to see this as a healing environment. Hard to ignore though that many of them were institutionalised for life, often against their wishes, with very little treatment that had been proven to be helpful.

I tried to grasp these mixed feelings & felt perhaps that an Erasure piece might show & hold mine and others’ disquiet.

Sources:

Remington G, Addington D, Honer W, et al.: Guidelines for the Pharmacotherapy of Schizophrenia in Adults. Canadian Journal of Psychiatry. 2017; 62(9): 604–616.

Kane JM, Agid O, Baldwin ML, et al.: Clinical Guidance on the Identification and Management of Treatment-Resistant Schizophrenia. Journal of Clinical Psychiatry. 2019; 80(2): 18com12123.

Taylor DM, Barnes T, Young A: The Maudsley Prescribing Guidelines in Psychiatry. 2021.

Scott A: The ECT handbook: the third report of the Royal College of Psychiatrists’ Special Committee on ECT. 2005.

Pompili M, Lester D, Dominici G, et al.: Indications for electroconvulsive treatment in schizophrenia: a systematic review. Schizophrenia Research 2013; 146(1–3): 1–9.

Phutane VH, Thirthalli J, Kesavan M, et al.: Why do we prescribe ECT to schizophrenia patients? Indian Journal of Psychiatry. 2011; 53(2): 149–151.

https://research-repository.st-andrews.ac.uk/bitstream/handle/10023/20095/Houston_2019_Asylums_Lancet_Psychiatry

https://www.psychologytoday.com/gb/blog/freud-fluoxetine/201811/brief-history-electroconvulsive-therapy

[Papers were requested from the Gartnavel/Wellcome archive pertaining to Electroconvulsive Therapy which have not been digitised for reasons of Data Protection. The project is grateful to the Wellcome Trust for making this material available for private research].

A slam-winning Granny, Finola Scott performs all over the UK. She has read at the Edinburgh International Book Festival, the Wigtown Book Festival, in Rosslyn Chapel and at the Scottish Parliament. Her poems are personal and political, from the intimate to the world view. They appear on posters, tapestries and postcards, and are heard on radio and in podcasts. Her work is published widely, including in The High Window, I, S & T, The Lighthouse and One Hand Clapping.

Finola’s poems have gained success including twice winning the Uist Poetry Prize; placing in the Coast to Coast and Blue Nib’s pamphlet competitions; recently she was a winner of Paisley Museum and Art Galleries’ competition celebrating artist John Eardley. The StAnza poetry festival commissioned Finola’s work for a multi-media installation. Red Squirrel published her first pamphlet, Much Left Unsaid. She is one of three women featured in Tapsalteerie’s forthcoming anthology, modren makars.

Visitors’ Lounge

Finola Scott

Visitors’ Lounge

Audience more like
May the circle be unbroken
We take our seats as you direct.
Hands origami  on laps we
listen try
to work out  new parts Try
not to stare at the parcel
that is  you in here unkempt hair
crumpled trousers plaid slippers
Lord, by and by
We echo your breath  don’t
dare disagree  introduce fresh patterns
we exercise
caution following
always following  There’s a better home
awaiting in the sky, Lord
We try to be patient.

Blitzkreig

shocking & I’m shocked
dancing frogs legs  Jane Austen
cavorting in Bath
gym-slipped Madame Curies
we tell ourselves
it’s Science  modern important

shocked that we don’t talk
you travel out  the cheery blossomed way
lie down grateful  for this blessing
I don’t ask   question your peace
subject off limits
shocked

Ponders End

1
The Edison Swan Electrical Co
shock therapy
apparatus  serial No. 12257/7
supply the new type
of headbands and electrodes
return  the old harness
yours faithfully
Senior Assistant Physician

2
convulsions
shock voltages
up to 150 volts current
up to 500 mA
Advantages     low cost  portability
robustness  ease of operation
freedom from risk
of accidental shock

3
treatment under a cloud
two        distressing     accidents
both femurs
fractured
over   50 years     of age
appalling
failed          to diagnose         deluded
this can occur          this
particular                 treatment

strike a swift, focused blow at an enemy using mobile, manoeuverable forces,
an attack ideally leads to a quick victory, limiting the loss a lightening war

A        blitzkrieg      is a     fast       and       intense         military attack that takes
the          enemy       by      surprise
and is          intended        to      achieve      a very         quick      victory.
the ‘concentration principle,’ the idea that concentrating forces against an enemy, and making a

single blow against a carefully chosen target (the Schwerpunkt, or ‘centre of gravity’) was more

effective than dispersing those forces.

Commentary

The information about the former residents/patients of the hospital that Gillean McDougall supplied to participants in Writing the Asylum was compulsive. As I still remember the disturbing experience of going with a friend in the late 60s to visit his sister in Gartnavel who was suffering from profound postnatal depression, the project had a personal dimension.

I was shocked to read that my friend’s sister was not alone. According to a research paper published by St Andrew’s University, ‘Some 150,000 people resided in UK asylums in 1954, a rate per head of population nearly 7 times greater than 1800. At that date half of all NHS hospital beds were given over to patients with mental illness or impairment.

However as this project started, my life became complicated – 6 bereavements of friends in 4 months. On top of this the purchase of new home fell through 2 weeks before my planned move. I sat surrounded with boxes I had packed returning from funeral after funeral. So selfishly, I couldn’t face examining the difficulties of individual patients’ lives.

Instead I turned to other memories and family stories. I remembered that a relative had been a patient attending Gartnavel. I didn’t know why, except that ECT was part of the treatment. This had always interested me as for a while it had been a controversial treatment. However although I remember my relative being happy to attend the hospital and happy to repeat the treatment the whole thing was treated not only as private but as a secret even within the close family.

The Wellcome Trust allowed me access to fascinating documents which are not available in the public domain via the website – ranging from articles in professional journals as well as correspondence between staff at the hospital and the firm supplying the ECT equipment. By co-incidence I was chatting in a group with a poet friend who asked what I was working on. When I mentioned the ECT, one of the people in the group cheerfully told us that his father had received this treatment. He went on to outline the improvement in his father’s moods. I was fascinated by the openness of this in contrast with the secrecy surrounding my family situation.

Another co-incidence was learning about conditions in asylums when reading The Silent Weaver by Roger Hutchinson. This book told of Angus MacPhee who spent most of his adult life in institutions after the Second World War. Various treatments used at the time were examined including ECT. The author shared a view I had read elsewhere – that the film One flew over the Cuckoo’s Nest was in part responsible for the current negative attitude to this treatment.

It seems that the jerking spasms which led to patients breaking bones had occurred in early administration of ECT. It had been observed that after seizures, epileptics appeared to be relieved of psychotic symptoms. Drugs were then used to induce similar seizures. Wanting to replicate this effect without the use of drugs doctors turned to ECT. Ironically it was the restraints, used to attempt to protect the patient from harm resulting from uncontrolled jerking, that resulted in injury. Later this dreadful situation was avoided when patients were sedated before receiving the carefully measured current. Unfortunately letters to the Swan Electric Company from doctors at Gartnavel reveal that patients’ broken limbs had not been diagnosed immediately. No wonder ECT had a bad reputation. However I gathered the impression that it helps with a range of conditions including treatment resistant cases of depression and in some cases of bipolar affective disorder and schizophrenia.

This extract from a research document included in the Wellcome papers seems to support that idea: ‘Clozapine-resistant schizophrenia remains a major challenge in the practice of psychiatry with limited evidence-based intervention.’ (Remington et al., 2017). Most people with this condition, the majority of whom are relatively young, lead their lives with substantial subjective distress and disability. Electroconvulsive therapy (ECT) is sometimes recommended by clinical practice guidelines (Kane et al., 2019;Taylor et al., 2021) and is commonly prescribed for this condition.

However it is worrying to read: ‘In the context of poor-quality evidence supporting the use of ECT in treatment resistant schizophrenia, the report of the Royal Claims for the efficacy of ECT in treatment-resistant schizophrenia would perhaps best be described as a triumph of anecdote over empiricism (Scott, 2005). Despite this scepticism, treatment resistance is one of the commonest indications for ECT in schizophrenia across the world (Pompili et al., 2013; Phutane et al., 2011). Thus, ECT is commonly prescribed worldwide for an indication with inadequate evidence.’

It was odd to see that the Swan Electric Company supplied much of the equipment. This jarred as I remember that the electric kettle in my childhood home was supplied by Swan. I felt a gap between the purpose of these electrical implements.

Walking the grounds of the hospital was confusing. On the surface it was pleasant to think of past patients happily working, growing vegetables and herbs. It was too easy on a bright day to see this as a healing environment. Hard to ignore though that many of them were institutionalised for life, often against their wishes, with very little treatment that had been proven to be helpful.

I tried to grasp these mixed feelings & felt perhaps that an Erasure piece might show & hold mine and others’ disquiet.

Sources:

Remington G, Addington D, Honer W, et al.: Guidelines for the Pharmacotherapy of Schizophrenia in Adults. Canadian Journal of Psychiatry. 2017; 62(9): 604–616.

Kane JM, Agid O, Baldwin ML, et al.: Clinical Guidance on the Identification and Management of Treatment-Resistant Schizophrenia. Journal of Clinical Psychiatry. 2019; 80(2): 18com12123.

Taylor DM, Barnes T, Young A: The Maudsley Prescribing Guidelines in Psychiatry. 2021.

Scott A: The ECT handbook: the third report of the Royal College of Psychiatrists’ Special Committee on ECT. 2005.

Pompili M, Lester D, Dominici G, et al.: Indications for electroconvulsive treatment in schizophrenia: a systematic review. Schizophrenia Research 2013; 146(1–3): 1–9.

Phutane VH, Thirthalli J, Kesavan M, et al.: Why do we prescribe ECT to schizophrenia patients? Indian Journal of Psychiatry. 2011; 53(2): 149–151.

https://research-repository.st-andrews.ac.uk/bitstream/handle/10023/20095/Houston_2019_Asylums_Lancet_Psychiatry

https://www.psychologytoday.com/gb/blog/freud-fluoxetine/201811/brief-history-electroconvulsive-therapy

[Papers were requested from the Gartnavel/Wellcome archive pertaining to Electroconvulsive Therapy which have not been digitised for reasons of Data Protection. The project is grateful to the Wellcome Trust for making this material available for private research].

A slam-winning Granny, Finola Scott performs all over the UK. She has read at the Edinburgh International Book Festival, the Wigtown Book Festival, in Rosslyn Chapel and at the Scottish Parliament. Her poems are personal and political, from the intimate to the world view. They appear on posters, tapestries and postcards, and are heard on radio and in podcasts. Her work is published widely, including in The High Window, I, S & T, The Lighthouse and One Hand Clapping.

Finola’s poems have gained success including twice winning the Uist Poetry Prize; placing in the Coast to Coast and Blue Nib’s pamphlet competitions; recently she was a winner of Paisley Museum and Art Galleries’ competition celebrating artist John Eardley. The StAnza poetry festival commissioned Finola’s work for a multi-media installation. Red Squirrel published her first pamphlet, Much Left Unsaid. She is one of three women featured in Tapsalteerie’s forthcoming anthology, modren makars.