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Festival of Ideas (1): The Song of Doctor Hunter

Tonight sees us perform our performance/lecture Time Out of Mind for the Festival of Ideas. It explores the history of Mental Health care (or otherwise) in York and how these lessons from the past might affect the future of services, particularly around the issue of Bootham Park Hospital, in our city.

Our next blog will focus on the event itself but we wanted to take this opportunity to reflect on the work of the man who was first put in charge of the hospital, Dr. Alexander Hunter. Whilst not a great deal is known about the consulting physician what we do know is not entirely encouraging. In our lecture we present some of his ideas, not uncommon for his time, through the performance of a satirical song.  For those of you unable to join us tonight we would like to take you through some of those lyrics and the questions they raise...  

In response to certain accusations I am duty bound to respond to certain fudges and false rumours, this damned hum that I, Doctor Alexander Hunter, am neglecting my patients and that there is some havey-cavey business at the York Lunatic Asylum. I do beg your indulgence to allow me to finally respond…with a song.
— The Song of Doctor Hunter

When Bootham Park Hospital, or York Lunatic Asylum as it was first called, opened its doors in 1777 it was as a private practice. Although public subscriptions were made for its building the running of the hospital was also a commercial venture.

It’s a true fact, that madness costs money
Two hundred a year? It’s not terribly funny
That a man such as me, a consulting physician
should have pockets to let, a pauper’s position.
— The Song of Doctor Hunter

The tension between providing quality health care and a healthy profit began almost immediately. In fact, Dr. Hunter seemed to resent the parish poor being admitted to the hospital. The parish contribution to their care was not enough to house, feed and treat these patients. It was not surprising then that the quality of care for the poorer and his richer clients was not exactly equitable and Dr. Hunter set up a separate and more lucrative practise alongside his work in Bootham.

Eight shillings a week from all of the lowly
I’m doing God’s work, I’m really quite holy,
They’re dropping like flies, soon off to heaven
It must be their illness, a happy progression. Yet…

you accuse me of ne-glect and murder!
Hannah Mills died, it’s simply absurd-that
it was ‘due to her care’ and not to her character
She was a quaker and madness her predator.
— The Song of Doctor Hunter

During that time the number of people who died in Bootham was alarmingly high. A crises point emerged when a local Quaker, Hannah Mills, was admitted. Many of her co-religionists tried to visit her but were refused admission. When she died a month later it led to both an outcry and to the building of a 'rival' asylum, which was to be run on more humane terms. This quaker institution still serves mental health service users today and is named The Retreat.

After I’m gone, and upon your ascending
you need to think on how to cut spending
patients don’t need a bed, meal or bath
so clap them in irons and feed them your wrath. Oh yes!

Be cruel to be kind! This is so essential
Pack them crowded all in. Maximise residential!
In matters fiscal, You must be cock-sure
unpleasant secrets kept behind our closed doors.
— The Song Of Doctor Hunter

Hunter fought against transparency on the grounds that this was a private practice. He groomed a successor, Dr Charles Best, who followed Dr. Hunter in keeping what went on 'behind closed doors' - behind closed doors. When a reforming magistrate first got involved in the campaign to change the practise at Bootham it was largely because Dr. Best was reluctant to engage and properly communicate what really was going on.  We will tell the story of that campaign, the media war and the dramatic turn of events  through a rehearsed reading of a mini-play, Abuse and Admonition, at tonight's event.

So issues of commerce, care, neglect and transparency all come into play through The Song of Doctor Hunter and Abuse and Admonition, but there are many other interesting stories to tell. Alongside the main lecture, delivered by Dr. Nick Rowe, there will also be guest appearances from Dr Patrick Kay playing an original character reporting on the mixed motivations for the building of the hospital, Dr. Stephen Wright playing 20th century reformer Sir. Frederick Needham, In the Moment performing their devised piece on what future health care could look like and another contribution from us  relating present day stories of Bootham. This is not a history lesson for,as Kierkegaard once said, 'Life can only be understood backwards; but it must be lived forwards.'  We hope you can join us in thinking about and, perhaps shaping, our future.  You can book tickets here