On Esca’s Flow’ry Bank

This is the talk I gave to the Civic Trust Conference on the 29th October 2014. The Conference was entitled “FEELING GOOD: Wellbeing & the built Environment”.

The Civic Trust Conference for 2014 was held in Maryhill Burgh Halls. This was a wonderful and inspiring venue:

I presented on Mavisbank House. I argued that heritage can matter for our collective wellbeing.

I had to follow Sir Harry Burns, recent Chief Medical Officer for Scotland.

Sir Harry carries the same view as I do: that the social determinants of health must be included in our understanding of “wellbeing”

My talk follows. It was the last of the day.

Slide 1: My name is Peter Gordon. Thank you for inviting me to give a talk. I doubt I can follow the wonderful speakers so far. But I will do my best. I will try to keep to 20 minutes. I have attempted to keep my slides uncluttered as this is the last talk of the day and if your mind is anything like mine you may be getting tired.

Slide 2: I am here today to give you a short story of a long life. My talk will be about a ruined early 18^th century house called Mavisbank seven miles out of Edinburgh and on the banks of the river Esk

Slide 3: Buildings and spaces play an inescapable role in shaping the quality of our lives; they have the power to restore and promote civic pride, community resilience, mental and physical health and be a source of happiness.

Slide 4: The title of this talk comes from the epic poem THE COUNTRY SEAT by John Clerk of Mavisbank

SLIDE 5: John Clerk of Penicuik was one of the fathers of the Scottish Enlightenment, which was to bring the Age of Reason, the Age of Improvement and the Agricultural Revolution, an explosion of interest in science and nature, the Industrial Revolution, the growth of trade and the foundation of the British Empire

John Clerk was a polymath. Born in 1676, he studied at Leyden under the great Hermann Bouerhaave, went on the most ambitious Grand Tour of his generation, learning languages, mathematics, law, architecture and music – including composition under Corelli. He became an advocate, a member of the Scottish Parliament and, in 1703, a member of a committee to examine the public accounts of Scotland. In 1707 he was one of the Scottish Commissioners who negotiated the Union with England.

SLIDE 6: Adam, on the other hand, was a tradesman, the son of a mason in Kirkcaldy, a town on the north shore of the Forth which was also the birthplace of Adam Smith, more recently associated with linoleum and Prime Minister Gordon Brown! He was to become, in that famous description: ‘the Universal Architect of his Country’.

SLIDE 7: Here we have Mavisbank as recorded in Vitruvius Scoticus

SLIDE 8: Here is Mavisbank in a watercolour dated around 1850 or so

SLIDE 9: Here is Mavisbank in 1989 as featured in the Scotsman. The scrapyard belonged to the notorious rogue and friend of the Bay City Rollers, Archie Stevenson. 16 years before this photograph Archie Stevenson had set Mavisbank ablaze. He never got the Insurance money and so from then on Mavisbank was roofless and its degradation accelerated.

SLIDE 10: Upon Mavisbank John Clerk had these words inscribed in Latin. They will be difficult if not impossible for you to read. Translated, the words end as follows:

SLIDE11:

“and grow old either never or late
May the decay of great age be restored intact,
So that the older you become,
The more beautiful you may shine”

SLIDE 12: As a doctor in medicine for our older generations I fell in love with this closing passage. As an artist I thus made a sculpture carrying this inscription on a simple block of stone of the exact proportions of Mavisbank. I called this “The Ageing Stone”. It is perhaps an expression that ageing is real and that we must be careful in simplifying “disease”

SLIDE 13: Last week I attended a Conference in Glasgow for Alzheimer’s Europe. Here, our Health Secretary for Health & Wellbeing, Alex Neil, spoke passionately about rights and dignity for those living with dementia.

SLIDE 14: One of the talks was about the language we used when referring to dementia and indeed ageing. “Timebomb” “Explosion” “all out fight back” “epidemic” … as I read all these metaphors of loss my mind returned to my sculpture and the lessons I have taken from Mavisbank’s rich history.

SLIDE 15: At the same Conference. We were given this “toolbox” (not a term I like as I associate tools with mechanics and machinery not human beings). Do not try to read all this slide but look at the bottom of the list where it says “it is estimated that 2/3rds of current UK prescriptions of antipsychotics for people with dementia are inappropriate”

These are very strong medications with many potential adverse effects. The question that came to my mind, and a question that I raised at the Conference, was how we came to this harmful approach in our most elderly and perhaps most vulnerable?

SLIDE 16: Another slide from last week’s conference that made me think of today’s conference. Here we have the consideration of an Italian nurse in 2014:

“Cure does not mean always heal, but to take care of”

SLIDE 17: So why on earth might Mavisbank and its designed landscape help us here? I hope to explain how Mavisbank has a very important lesson for health and wellbeing today.

SLIDE 18: The 18^th century designed landscape of Mavisbank is a forgotten gem of Scotland: with its alleles, goosefoot, admixing the formal with the informal, and nature with man.

SLIDE 19: Here in Holland we find a project called Demen Talent where individuals living with dementia are involved in restoring and maintaining a landscape around a modern cathedral.

SLIDE 20: It is an inspiring project that has brought wellbeing beyond any medications and has empowered the individuals, brought a sense of renewed worth and reminded the world that we should not see those with mental or physical illnesses as somehow “others”

SLIDE 21: back to Mavisbank in its decline. How might it help us in Scotland?

SLIDE 22: My view is that it could, in a new enlightened age, help all ages to find health wellbeing

SLIDE 23: Here we need take the broad view in addition to the microsope of the scientific lens. Indeed a fully pluralistic approach that is necessary for health & wellbeing. An approach that does not artificially divide the Arts from the Sciences.

SLIDE 24: Scotland can be rightfully proud of its role in the so-termed Enlightenment. But we must be wary of any overly simplified revisionist history.

SLIDE 25: Hippocratic medicine you will all know of: the oath that doctors take and the basis on four humours. However you may not have heard of the Aesculpian doctors. They re-flourished in the time of Mavisbank. This approach advocated that healing was an art as well as a science. The Aesculpian club began in Edinburgh and it was here that the doctors re-visioned a future for Mavisbank as a retreat for those with nervous complaints.

SLIDE 26: In 1878 the new Mavisbank Asylum opened. It remained a hospital until the years that the NHS began.

SLIDE 27: One of the doctors crucially involved with Mavisbank was Dr Joseph bell. You may have heard of him? If not I will give you a clue!

SLIDE 28: Dr Jospeh Bell was the boyishly good looking Edinburgh physician who so impressed the doctor in training, Arthur Conan Doyle.

Doyle later confirmed that his fictional character, Sherlock Holmes, was based on Dr Joseph Bell.

SLIDE 29: One of the other doctors who pioneered Mavisbank as a retreat was Professor Charteris. This Edinburgh doctor discovered that aspirin was useful in treating fever. He thus ushered in modern therapeutics.

A host of other Mavisbank doctors considered and wrote up emerging medications f the time. Here Dr Keay considers Chlorobrom for mental diseases. The potential beneficial effects of this antihistamine for nervous complaints was later debunked.

SLIDE 30: At the turn of the 20^th century Mavisbank was renamed “New Saughton Hall” after Sir John Batty Tuke moved his patients from Gorgie in Edinburgh.

SLIDE 31: Mavisbank had at least eight different Superintendents in its 75 year span as a hospital.

SLIDE 32: In its time Mavisbank was operating in medical misogyny. So it is rather wonderful to make clear who REALLY ran Mavisbank. This was Mary Elizabeth Burton (1865-1944) who can lay claim to being the first woman in Scotland to obtain a post as head gardener and in a career that spanned over four decades. It was her professionalism and horticultural expertise encouraged a growing acceptance of women gardeners in the first half of the twentieth century.

SLIDE 33: Mary Burton arrived in Mavisbank in 1896, the gardens and policies extended to 120 acres. She worked hard in her new position and proved to be just as capable as her male colleagues. After a short period, Mary was promoted to head gardener, becoming the first woman in Scotland to hold such a position.

SLIDE 34: I am currently one of the Trustees of Mavisbank along with many far more able than I am. One of my fellow trustees is David Harrowes. This is a picture of his father, Dr William Harrowes, or “Dr Bill” as he was affectionately known.

SLIDE 35: Dr Bill loved Mavisbank and set about its restoration to its former glory. At the same time he carried on in his job as a psychiatrist. He also wrote this book “Human Personality and its Minor Disorders”. I can tell you its stands up very well in time and has many reminders important for health & well-being today.

SLIDE 36: In my span as a doctor (I have been practising  for 23 years now) the predominant paradigm for mental disorders has been a biological one. This has brought forward symptomatic treatments of some effect but has not really helped us understand mental disorders in a pluralistic way to science. In recent years I have seen a change in scientific discourse to include us in the world we live in and not apart. Isolated brain research is important but taken out of context understandings can go awry.

So here is an article about the value of therapeutic space in the latest Journal of British Psychiatry. It is my view however that my profession must try harder to see the healing value of the world we live in. Sometimes I think the Victorians understood this better than us. Mavisbank is a case in point.

SLIDE 37: For the next few slides, with the backdrop of Mavisbank I am going to share a few short quotes from my book on Mavisbank called “Repeats its Love”

SLIDE 38:Dr Bill was trained under Dr Meyer who kept reminding mankind, that despite all our wonderful advances, that we must not be understood simply as biology gone wrong

SLIDE 39: “Everything should be made as simple as possible, but not simpler.” Albert Einstein

SLIDE 40: “I forecast that psychiatry’s presently one-sided neurobiological and pharmacological model will gradually return to the midpoint of Engel’s model – when the former discovers that drugs are not panaceas and that there is more to the human being than the brain”  Edwin Wallace, 2007

Slide 41: ‘The good physician treats the disease; the great physician treats the patient who has the disease’ Sir William Osler

SLIDE 42: “We study the whole man and his setting, and not only the parts of man.” Dr Bill often quoted this remark of Dr Meyer

SLIDE 43: Here is the great-great grandson of John Clerk who built Mavisbank as his county villa. You may recognise him? Yes this is James Clerk Maxwell who Einstein regaled. It was James Clerk Maxwell who “saw” the invisible energy in fields around atoms that exists in waves. Clerk-Maxwell punctured a hole in materialism. Today, worldwide communications and technology are based on James Clerk Maxwell. He was also a poet. He is a hero of mine.

SLIDE 44: Mary Burton a heroine. She stood for understanding, respect, level playing fields and full inclusion.

SLIDE 45: And John Clerk himself. A polymath who resisted artificial boundaries between arts, culture, science and well-being.

Surely these good Scottish folk are telling us something from today’s collapsing ruin – of what many understand as Scotland’s – finest early 18^th century house.

SLIDE 46: And here is James Simpson, who is an example for today. It was James who saved Mavisbank from the bull-dozer and who asked me today to present to you. James, like me, can see a new future for Mavisbank.

SLIDE 47: The restoration of Mavisbank has proved exceptionally difficult for reasons too many to explain just now. But the Trust does have a Vision that it is most passionate about and which is entirely in keeping with the theme of today:

The Scottish Government aims to ‘focus on the contribution that culture can make to improve the health, wellbeing, confidence and quality of life for our communities’

SLIDE 48: Following this approach, with Mavisbank is a place of retreat from a busy life, a place of inspiration and in turn a place of growth which offers an opportunity to address needs in the local community and bring public benefit to individuals and the wider community.

It is difficult to develop a form of words that explains the vision better than Clerks…

Would you unbend your thoughts, and thus acquire fresh oyl to lighten up the vital flame?

This might be translated for today as ‘Mavisbank – a sanctuary of inspiration and restoration’?

SLIDE 49: My determination is to fuse my two careers to bring Mavisbank to the attention of all those who seek a healing landscape and true community place for creativity and renewal. My profession is beginning to take a broader approach to well-being and I welcome this. As you can see from this recently advertised conference; “Environment, Society and Psychiatry”

SLIDE 50: I want to finish with our vision for Mavisbank. I hope you might help the Mavisbank Trust in supporting this vision and talking about Mavisbank with as many folk as you can. We have 6 categories that comprise our vision