Last week, when in Aberdeen, I came across this sign for ‘SIBERIA’.  It reminded me of several old  contributions to hole ousia [copied below]:

[1]  SIBERIA [17 May 2019]

I came across this headline in today's paper. This headline reminded me of a visit that I took last year to Siberia! This was in the months before I decided to fully retire as a doctor.

[To play my short film SIBERIA please click here or on the image above]

The Porsolt Forced Swimming Test (Behavioural Despair Test) is centred on rodents’ response to the threat of drowning. It has been interpreted as measuring susceptibility to negative mood in humans. It is commonly used to measure the effectiveness of antidepressants in rats.

The following is a poem written by me about this test. I wrote it in my mind on my way to Siberia. Once at Siberia I jotted it down in my commonplace notebook. This Siberia is a farm, now a ruin, in the East Neuk of Fife. It should not be confused with the extensive geographical region spanning much of Eurasia and North Asia.

The poem recounts the friendship of two rats: one rat is called ‘Hippocraticus’ and the other rat ‘583’. Hippocrates is often referred to as the “Father of Medicine”. Agnes Richter was a psychiatric patient and seamstress. She made herself a jacket whilst under psychiatric care. It seems that she was known as ‘patient 583’ and so she stitched this label into her jacket.

The Royal College of Psychiatrists has stated that “We know that in the vast majority of patients, any unpleasant symptoms experienced on discontinuing antidepressants have resolved within two weeks of stopping treatment”.

Dr William Sargant (1907-1988) was a British psychiatrist who is remembered for the evangelical zeal with which he promoted treatments such as psychosurgery, deep sleep treatment, electroconvulsive therapy and insulin shock therapy. He wrote, with Dr Eliot Slater, the influential Textbook: “An introduction to physical methods of treatment in psychiatry”.

“Real Psychiatry” is a blog written by an American Psychiatrist. In terms of psychiatry in the UK a new textbook is to be published this month: it is titled “The Medical Model in Mental Health: An Explanation and Evaluation”

Aye its cauld, like Siberia! Says rodent ‘583’
So keep swimming Hippocraticus
ye wud’nae want to SINK.

Keep swimmin’ Hippocraticus
We’re being ‘evaluated’ did ye nae ken?
And all will be ‘resolved’ when we stop

Did ye nae hear:
Dr Sargant is giving a talk on ‘values and feeling valued’
Aifter a plush dinner at some Royal Society or anither!
So keep swimming Hippocraticus.

There’s gan tae be a Text book aboot us –
it will “explain” how we feel
based on the new brain cells that grew in oor brains
before we drooned.
The Text book is to be called “REAL PSYCHIATRY”

Keep swimming Hippocraticus!
“The Rules of Science”
are credible
and we
are not.

“I am sae tired 583
I don’t hae strength to swim much longer
Gie me a ‘choppy sea’ any day
tae P O R S O L T”

Keep swimming Hippocraticus! [rodent 583 is close to tears]
The imbalance is not oors.

Hippocraticus [sinking]
Is now dead.
[Dr Sargant enters the laboratory
and prepares the PORSOLT glass beaker for 583.]

[2]  BRITAIN’S SIBERIA [11 October 2020]

Fifteen years ago the following paper [shared in full below] by Dr Allan Beveridge was published in the Journal of the Royal College of Physicians of Edinburgh. The paper explores an account given by Mary Coutts of her experience of the asylum system in 1909. This account was published in a pamphlet: ‘BRITAIN’S Siberia: The High Statistics of Insanity Explained by a Certified Lunatic”.

Allan Beveridge’s published writings on the history of psychiatry demonstrate an approach that is  careful, thoughtful, and well-researched. I have learned so much about the history of psychiatry from Allan. However, I somehow missed this particular publication and only recently came across it by chance after coming across the headline “BRITAIN’S SIBERIA”  in a newspaper archive. There was a little more than serendipity to this, in that I had recently written a completely unrelated poem and made a short film about visiting an abandoned farm in Fife that was once known as ‘SIBERIA’.

Allan Beveridge offers a balanced description of Mary Coutts’ account and in addition provides that which was recorded in her medical (asylum) notes. In this post I have been able, thanks principally to on-line archives that have since been made available, to share further information. As well as some limited biographical details of Mary’s life, this includes published correspondence between Mary and a range of individuals involved in the asylum system including fellow patients.

I have a few further thoughts to offer on ‘BRITAIN’S SIBERIA’, noting that like Allan, I am now a retired NHS Psychiatrist.

(1) Whilst I have serious concerns about the overall validity of ‘Pathography’ [retrospective study that focuses on a person’s illnesses, misfortunes, or failures], I can  understand why Mary Coutts did end up requiring hospital care.

(2) Whether mentally-ill, not-ill, or somewhere in-between, we need to be careful about making conclusions based on a Pamphlet and Medical Notes alone. As Allan Beveridge makes clear, the culture of Mary Coutts’ world cannot be re-experienced and it would be misguided to believe that ‘absolute truth’ can be established. In the additional archive material below are some reminders that this wider culture was not just the world in which Mary lived, but also the world in which the asylum system operated. Neither Mary nor the system could be detached from this.

(3) I was immediately struck by the sub-title of Mary Coutts pamphlet “The High Statistics of Insanity”.  Today this concern has found different forms of expression. Academia generally uses the term “over-medicalisation”, the BMJ  uses the term “Too Much Medicine”, and the  Scottish Government, “Realistic Psychiatry”.  It would seem that, with the passage of time, the concerns of a “certified lunatic” have become the concerns of the “establishment”.

(4) My last thought relates to some of the further archive material [shared below]. The letters between Mary Coutts (a patient) and professionals (those in positions of authority) indicate significant, if understandable, defensiveness. More than a hundred years later I am aware of similar defensiveness today, and the report First Do No Harm by Baroness Cumberlege has considered some of the harmful consequences of this.

Further archive material [presented in chronological order]:

Before September 1887: Mary MacDonald meets George Coutts at their place of work. Mary is a ‘Machinist’ and George is a ‘Clerk’

28 September 1887: Mary Macdonald marries George Coutts:

23 May 1905:  Mary’s mother dies at Kingseat Asylum:

15 May 1906: Mary’s husband is appointed organist for Skene Parish Church:

15 May 1908:

From 18 March 1908 – to 14 July 1908: Mary Coutss was detained in Aberdeen  Asylum:

9 January 1909: Century Press, London publishes Mary Coutts pamphlet:11 January 1909: A summary of  ‘BRITAIN’S SIBERIA’ is published  in JUSTICE:
30 January 1909: Dr Solomon Herbert, MD, letter, published in JUSTICE:

30 January 1909: Mary Coutts responds to Dr Herbert [as published in JUSTICE]:

6 February 1909: A letter by a ‘Heartbroken sufferer’:

6 February 1909: A letter from A J Marriott:

13 February 1909: M A Simmons, an Asylum Nurse Attendant:

13 February 1909: Mary M Coutts [letter of response]:

13 February 1909: Dr Solomon Herbert, MD,  second letter, published in JUSTICE:

30 October 1909: Editor of JUSTICE:

17 November 1909: In the Aberdeen Press and Journal:

20 November 1909: In the Aberdeen Press and Journal:

8 December 1909: In the Aberdeen Press and Journal:

18 December 1909: The Fermanagh Herald:

2 April 1911 Census: 108 Osborne Place, Aberdeen: George Coutts with son George and daughter Mable [Mary Coutts is not present]

22 September 1928: Death of George Coutts [at time of death living at 124 Osborne Place]:

October 1928: The following month, son George Coutts emigrates to Canada:

January 1931: Mary Coutts advertises Lodgings to let in Bon Accord Street:

14 January 1935: Mary Coutts dies in Kingseat Mental Hospital

I was the very last doctor at Kingseat, working the last night before closing for good the next morning:
Kingseat Hospital, Newmachar, Aberdeenshire: