A Visit to Bedlam
Everyone who visited London visited Bedlam as a matter of course. The hospital was one of the great sights of the city. Hezekiah had already seen the great cats in The Tower for a silver sixpence, bought sedition in St Paul’s churchyard, viewed the rebel parliament in Westminster, and paid a boatman to shoot the arches of the bridge. He would have taken in a play at The Red Bull but the theatres were still closed. His younger brother Elias had arranged the trip for him. Elias had been most accommodating since Hezekiah’s wife and son had died. Usually they argued like only brothers can, but he had seen to the estate and organised the journey without complaint, even eagerly. A way to escape the grief, Elias had said.
The shadows were lengthening as he arrived at Bedlam’s west gate. The visit cost half a crown, but the investigations were worth the expense. The whole trip had been expensive. Hezekiah smiled to himself; Elias was usually the spendthrift in the family.
The porter was waiting for him at the gates holding an oil lamp: a short squat man, thick lipped and heavy browed. He lifted a bulbous red nose as Hezekiah joined him, sniffing like a dog over meat.
‘Welcome to Bedlam, sire,’ said porter, bowing. ‘Are you prepared for a spectacle of wretchedness and misery; an evening’s viewing of the grotesque and macabre to delight, disgust, and entertain?’
‘Yes, yes, indeed,’ said Hezekiah. ‘Am I the only visitor tonight?’
The porter nodded and held out a grubby hand like Charon demanding his fee. Hezekiah handed over the coin.
‘There are seven levels in Bedlam,’ said the porter, tucking the money into his ragged coat pockets. ‘The gates of hell are open night and day. Smooth the descent and easy is the way. But to return and view the cheerful skies, in this the task and mighty labour lies.’
He was laying on the theatricals thick and fast. Hezekiah was quite enjoying the showmanship of it all. The timing of the visit with the setting sun only added to the display. He was glad Elias had persuaded him to visit the hospital.
‘There are of mad-men as there are of tame,’ said the porter. ‘We have some so apish and fantastic, that play with feathers and are blemished and defaced. Yet, in spite of sorrow they’ll make you smile.’
Hezekiah smiled.
‘Others we have are like hungry lions, fierce as wild bulls, untameable as flies. With those you must have a care. Oftentimes they have snatched rapiers from a stranger’s side and done much harm. I must take the blade for your own safety.’
Hezekiah nodded at the warning and handed over his sword. The porter took it, turned, and led him through the crumbling gates of Bedlam.
Old stone and broken masonry; a sense of gloom hung over the hospital, oppressive and heavy. As they stepped over the threshold the evening sun dipped behind the horizon wreathing the monkish refectory in twilight and dark shadows. Hezekiah shivered as the temperature dropped. Gagging from the stench of the open sewer that ran beside the buildings (a filthy drizzle of excrement choked with filth, dead cats, and fetid water), he sniffed at a perfumed ’kerchief to stop from puking. The poisonous fumes cannot help the inmates’ sanity, he thought, taking out his journal and writing the detail down with a bit of pencil.
Every sight of his travels had to be recorded in his journal; every sound, every whispered word. Elias always grumbled about the time wasted on such vanities, but Hezekiah took no notice. Writing about his investigations was, he would tell friends, a petite obsession.
The porter nodded at the journal. ‘The inspectors had those when they came to see the spectacle,’ he said. ‘Cannot read or write myself.’
Hezekiah had heard about the inspectors. They had condemned the hospital as filthy and broken; the attendants as rogues and the treatments barbaric. He could understand why.
Inside the compound was a walled garden and pathway leading to the decaying buildings. Withered barren fruit trees, vegetable beds choked with weeds, untended, unloved and forgotten. He noted it all down. The porter took him through a tall archway into a cobbled courtyard. The dark buildings glowered over the space, leering like sailors in a stew. Hezekiah could feel the walls closing in on him. The sun had set; there was only the guide’s lamplight to show the way.
‘Welcome to the first level, sire. ’Tis destitution and despair, but they are no danger to anyone, just lost in misery. They wander sometimes; the locals know to bring them back. We do our best for them but they have no coin to pay their keep; no families to care for them.’ The porter shone his lamp around the square.
Hezekiah noted half-naked men, women, and children exposed in the shadows, all huddled against the stone walls. They turned to face him, emaciated countenances and dirty features. The smallest, just babes, crawled towards him, others held out their hands in a beggar’s greeting. A wave of guilt and pity came over him. These wretched creatures had nought, not even their sanity. He reached into his purse and took out his pennies, casting them at the destitute. They grabbed at the coins, fighting and cursing at each other like rats in a sack. Even though he was appalled, Hezekiah noted it all down in his journal. Bedlam was proving a salutary experience. He turned to the porter.
‘What next?’
The porter smiled, his broken rotting teeth stained black from tobacco.
‘This way, sire; this way to cures and remedies: the second level.’
He showed Hezekiah into a long building. A dull orange light cast by smoking tallow candles and a roaring coal fire, exposed a lunatic hanging chained to the walls. The madman was stripped to the waist with livid bloody welts marking a back crisscrossed with old scars. A dirty hospital attendant stood, like a sweaty masked executioner, with a thick birch to hand. He raised the cane and hammered it into the madman’s back with a wet thud, again and again. The prisoner screamed, howling, writhing in agony at the blow. He had loosened his bowels in the beating. The smell of faeces, blood and coal-smoke, the jumping firelight and dark shadows, gave it a hellish aspect.
‘A beating a day keeps the doctor away,’ said the porter.
Hezekiah grimaced.
‘You look disgusted, sire, but a good thrashing is a cure for the obsessives and some with a mania. They beat me day and night for a week but I was cured. Beat the devil right out of me.’
Hezekiah was not so certain of that. He turned away from the screaming patient. The air in the hospital was thick and heavy, choking at the lungs.
‘It does not work for all,’ the Porter continued. ‘Come to the third level, sire: the melancholic and the infantile.’
He took Hezekiah into a long straight corridor with a stale earthy smell on the air. At the end was an open cell lit by tens of candles and filled with dozens of carved wooden dolls; all dressed, and painted, and with real hair. A richly clothed young woman with wild dark ringlets, pale skin, and ruby lips sat on a stool in the middle of the cell. Her bodice and skirts were satins and silks, but Hezekiah noted that they were torn and stained. He stood at the doorway watching her, but she took no notice of her guests. Instead, she stroked the golden hair of a doll with a brush, humming softly to herself. With a pang of grief, Hezekiah was reminded of his late wife, reminded how she would brush their son’s blonde locks.
‘Who is she? She is beautiful.’
‘We call her The Satin Lady, sire.’
The guide explained that she had been raped by soldiers and lost her unborn babe. Since that sorry event she had regressed to childhood herself, playing with her dolls incessantly. There was little point in beating the melancholic healthy, the porter told him; it merely increased their misery. The family paid for her keep but never visited.
‘Which party was it? King or Parliament?’
‘What matters that?’
Of course it matters, thought Hezekiah. The details are important for my journal. Perhaps my words will bring attention to this poor creature’s plight. He was certain that his brother and friends would be appalled when he informed them of The Satin Lady. He wrote the story down, scribbling ‘caused by unknown assailant’ in his journal. A report to the governor and wardens of the hospital would not be complimentary about this gentlewoman’s condition.
‘Where next?’ Hezekiah asked.
‘Next is the fourth level sire: a purge and a vomit; a vomit and a purge, over and over again. Sometimes we bleed them, sometimes we don’t.’
The porter showed Hezekiah into a small tiled room. A solitary high backed chair with leather straps on the arms and legs to restrain the patients in the centre of the room. A large earthenware bowl was placed on the floor in front of the chair, and filled to the brim with black coagulating blood. He gagged at the foul stench but still noted all in his journal.
‘Bleeding them restores the balance of the humours, sire.’
Elias would send for the barber surgeon at least once a week for a bloodletting, but Hezekiah thought it a waste of money. Elias’s debts were another bone of contention between the brothers. He looked to the porter.
‘The next level is of peculiar and strange interest, sire: Old Jack.’
He took Hezekiah back into the corridor and down some steps to an open cell with metal bars, all lit up by rush candles. The occupant was completely naked on his straw pallet, and completely bald. There was not hair on his head or body. The madman turned to face them as the porter shone the lamp on him.
‘Come sit beside me, let me whisper in your ear; I will tell you my tale.’
Hezekiah looked to the porter; he would like to get the man’s tale for his journal.
‘You would want to do that not, sire. Old Jack be a biter and liable chew your ear off, literally and figuratively, so to speak.’
Hezikiah nodded and scribbled the details down in his book.
‘How long has he been here?’
‘Oh, a year or so now. He caused a scene at the shambles on Cheapside. Jack do insist upon running about naked, and well…’ The porter gestured to the madman’s depilated crotch.
‘What put him in this state? Has he always been like this?’
‘Nay, he was a soldier at Basing House, had a full head of hair and beard once. Watch this.’
The porter leaned forward to the grill. Jack watched them with glazed eyes.
‘Bang!’ shouted the porter.
Jack jumped up and screamed, throwing himself under his fetid bed and hiding, visibly shaking at the shout.
‘They say he got blown up by his own petard; been like it ever since. Be hours afore he comes out again. P’raps he be healed in time, p’raps there is hope.’
Hezekiah wrote Jack’s story down in his journal. He had seen men broken by the war before, there were too many wandering the three kingdoms. He leaned towards the parliament himself but was no zealot; Elias favoured the king. It had caused arguments at home. He looked at the porter.
‘Onto the sixth level?’
‘Onto the sixth level, sire: the incurable.’
He took Hezekiah downstairs. Sixteen steps to the bowels of the hospital. Hezekiah always counted steps, up and down, wherever he went. They could hear the howling as they descended. The noise was coming from behind a thick oaken door with metal hinges and heavy bolts. The porter opened a hatch to view the scene within. A man, if man it still was, dressed in grey rags, cut and scratched, matted hair and beard. There was faeces smeared over the walls; the stench of stale piss and stagnant air. When the hatch opened the howler turned to look at them, but there was no humanity in his eyes; there was no rationality or reason. The veneer of civilization was stripped away leaving only the dark beast within. Homo est animal rationale.
‘No cure has been found, sire. Not purging nor vomiting, beating or bleeding, even drowning and starving, nothing can bring him back to his sensibilities. We have tried everything again and again with no result. It be too dangerous to open up.’
‘What caused this?’
‘Heartbreak.’
Hezekiah could understand that. When his wife and son had passed it had driven him beyond distraction. His journals had helped, even Elias had helped, but the grief was still raw. It was as much empathy as pity when he looked at the monster in the cell.
‘Our hour is almost done,’ said the porter, closing the hatch. ‘There is only the seventh level remaining. The darkest, most disturbing, vision of all. Are you prepared, sire? Are you prepared for the mystery of the seventh?’
‘Yes,’ said Hezekiah, nodding.
He could feel his excitement building at the porter’s words. Clutching tightly at his journal, he followed the man down sixteen more steps to another heavy bolted door. The porter shot back the bolts, pulled the door open, and gestured for Hezekiah to enter.
‘What be this?’ said Hezekiah, stepping into the cell. ‘What be the seventh level?’
The cell was empty: a solitary wax candle flickering, a pallet, blankets, and bare flagstone floor.
‘The seventh level, sire? The seventh level is for you...’
The heavy door slammed shut. The bolts shot back into place.
‘No! No!’ Hezekiah screamed, hammering at the door. ‘Porter! Porter! There be some mistake! Porter! Take word to my brother, I beg you! Porter! He will explain; there be some mistake!’
‘’Tis for your own good, brother, and mine,’ came Elias’s voice from behind the hatch. ‘You are not right, not since she died. Worry not, I will see to the estate..., and the coin.’
“The gates of hell are open night and day; Smooth the descent, and easy is the way: But to return, and view the cheerful skies, In this the task and mighty labour lies.”
Virgil, The Aeneid.
Historical Note.
Treatment of mental health in the Seventeenth Century was particularly barbaric. Practices such as whipping, purging, drowning, bleeding and starving were commonplace. Bedlam had been established as a monkish hospital in the middle ages, but the dissolution of the monasteries had seen a decline in the hospital’s fortunes. Lacking in adequate funds to resource patient treatment, and with rampant corruption among the staff and board, the hospital had become a byword for misery by the 1630s. Charles I finally had the keeper dismissed on charges of embezzlement in 1633. The new regime was far more scientific in approach to their patients, but the interruption of the civil wars left the hospital in a financially precarious position. It was not until the Restoration that the old hospital at Bishopsgate was abandoned and a new building built in Moorfields.
The existence of PTSD before the advent of modern warfare is, of course, a matter of academic debate. However, we do have multiple sources referencing incidences of mental trauma caused by the civil wars on combatants and non-combatants alike.
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