Cane Hill Hospital - London 
London is a ruthless city - buildings that have served their purpose are quickly torn down and replaced - and yet Cane Hill still stands, almost fifteen years after it served its last patients. Built in 1882, it was once the largest building of its type, but it now lies derelict - a magnet for explorers, vandals, even filmmakers and artists. In the years since its closure it has acquired the reputation of being the ultimate abandoned asylum, the supreme embodiment of dereliction and decay. This is due mainly to the amount of equipment still on site - the extraordinary wealth of mementoes and personal information that still litter the corridors and wards – but also owes much to the asylum’s uniquely fearsome exterior. Viewed from the surrounding path, it feels more like a prison than a hospital. Even the name summons up images of some vacated battlefield; the location of some doomed last stand.
The building is now in a desperate state. The floor in several wards has disappeared while the ceiling in most corridors is close to collapse. With repeated arson attacks and continued weathering, it seems unlikely that many sections will survive beyond the end of the year. Perhaps the only factor now working in the hospital’s favour is its sheer scale. The building is so vast that even a concerted campaign by vandals couldn’t remove all of the curtains, smash all the furniture.
Poor security has greatly hastened the building’s decline. Once a fortress, in recent years, access has become considerably easier. Security have retreated to the main entrance, and the patrols have steadily decreased in number. Indeed, such is its reputation for laxity, one group were even so brazen as to park their minibus in front of the hospital. In the last few weeks, however, the pendulum has started to swing the other way. Security has been tightened; dogs once again patrol the interiors. It seems that the constant stream of visitors have prompted something of a rethink.
As at most other hospitals, there appears to have been little reasoning behind the items left on site. Many are too personal to justify neglect, while others certainly had the potential for reuse elsewhere. Inevitably, this leads to a rather confused atmosphere in some sections of the hospital. Occasionally, there is the rather eerie feeling of panicked flight - scared inhabitants, grabbing what they could before fleeing. The feeling in most wards, however, is rather closer to the reality – staff and workmen too overworked and underfunded to clear the hospital properly.
"I arrived at Cane Hill as a 21-year-old, frightened and overwhelmed. My first memory is of walking through the imposing entrance and being taken to Blake Ward where I was met by a junior doctor. Blake Ward had a large central day room with most of the chairs arranged facing the TV which was on most of the time. At the front of the room was a large chart which told us what day, date, month and year it was. There was a large window with a table beneath it and a piano which nobody played during the three months I was there.
The ward ran on a routine. You could get a hot drink from about 6am when the housekeeper arrived. Then breakfast was cereal and toast sometimes with hot food such as kippers, bacon etc. After breakfast there was occupational therapy for those considered well enough to go. At first I didn’t go to this but when eventually I did I found it pretty uninspirational sat around doing crosswords and sometimes they got the nail varnishes out. The art therapy was better and the art therapist was very encouraging..
..The one element that was alarming was safety and security – patients from other wards were allowed to wander in and some of the long stay patients seemed quite frightening to me. On one occasion I was in my single room when a very large female patient came into the room with a pair of scissors and said she wanted to cut my hair. That was scary! There were some escapes as well and then all the staff got quite frantic." - Jan (patient, 1989) *
Cane Hill has also been visited by hundreds of explorers – many of whom have inevitably tampered with the remaining furniture and paperwork. A wheelchair from Rossetti stranded in the pharmacy; the bizarre migration of ward reports from Hogarth to Ruskin - with the possible exception of the wards of Browning-Blake, very little in the hospital can be taken at face value.
"The patients from the long stay wards that were not locked shuffled the corridors or walked with an institutionalised gait, the men wore shabby hospital issue suits, and often the material had loud checks which were supposed to allow easy identification should one of them get lost down the town. Similarly, the women often were given floral print dresses and cardigans, again to make them more conspicuous should they wander into the community.
Female patients were often made up by the staff who, by trying to copy the fashion of a past era, made them look a bit like clowns, Aunt Sally scarecrows, almost like stage make up - and this also marked the patients out as mentally ill and from Cane Hill if they strayed down to Coulsdon. Haircuts were equally of the past, short back and sides for men and dated perms as a treat for the women."
- David Beales, The Road to the Asylum **
Most photographs of Cane Hill tend to accentuate its bleakness – black-and-white images of faded grandeur - and yet the thing that most struck me about the hospital was its colour. Admittedly most wards deferred to cream or pastels, but far greater flair was shown with decorations and fittings. In Lidgett-Lettsom, the curtains were a hypnotic, sun-infused orange, while elsewhere the kitchens were a dizzying collision of red and blue. Even the more personal remnants retained much of their sheen: luminous blue containers in the pharmacy, a burgundy dressing gown in Browning-Blake. And then of course there was green, each ward slowly being consumed by moss, mould and a glorious array of invasive plants…
"I remember Rose, a patient on Browning, an admission ward at Cane Hill. She would run around the ward in her pink nightdress and her pale blue dressing gown. She had been diagnosed as suffering from postnatal depression and was kept in a side room near the nurses’ office with her baby son. Her meals were brought up from the kitchen, she was considered too disturbed to have her meals with the other patients from the admission wards in the dining area on Blake ward. The nursing staff would verbally rebuke Rose even though this caused her distress, especially when they used medical terms that she did not understand, which they did more often when they discovered that this upset Rose..." **
"...What brought out the worst in them was when Rose set off the fire alarm. These fire alarms bells were, we were told, wired directly to the fire station. The nurses were more interested in preserving the peace on the ward than reacting positively to what was a cry for help from Rose, ... The nurses called the duty psychiatrist to the ward and Rose was written up for a Largactil injection to be administered when necessary.. Rose did not like the effect of the medication and when she recovered consciousness, resolved to set off the fire alarm at the next opportunity....The drug made her so dopey that she may not have even considered that this would cause her to be sedated again, but this is what happened after she set off the fire alarm again. Her baby had by this time been moved to the nurses’ office. Rose was again marched back to the side room and injected and locked up again. Rose accepted that setting off the fire alarm was not worth the trouble and when the staff were convinced that they could trust her they stopped locking her side room door...
...After a while when the fire alarm incident was almost forgotten and Rose had been quiet and well behaved on the ward she went to the charge nurse on duty (not one of the nurses with whom she had clashed) and asked innocently if she might have leave to spend a long weekend with her mother. On that Friday I was in Penge attending group therapy and I happened to see Rose and her mother walking down Maple Road in Penge on the other side of the street, walking in the opposite direction towards the high street. I didn't speak to them. I don't know if Rose saw me, she certainly didn't give any indication that she did see me. We got on well on the ward but I didn‘t want to impose on her leave. I am not sure exactly when over the weekend Rose threw herself under the train and ended her life. I was told back on the ward on Monday along with anyone else who knew and liked her." **
Beyond paperwork, traces of former patients were limited. .. A suit in a cupboard, Christmas decorations on the ceiling – but in most wards little else. A superabundance of machinery and furniture but nothing remotely personal. The only real exception came in the form of Browning/Blake – a ward to the south-west of the hospital. It has somehow survived thirteen years of visitors and vandals and remained much as it was when the hospital closed. Beds, mattresses and pillows are still in situ, as are the curtains and curtain rails. A dressing gown still hangs in a cupboard, while beneath one of the beds there is even a pair of slippers.
Many of the bedside lockers also contain cards, and there are dozens of special clothes-hangers, each inscribed with a patient’s name. Even the day room offers several insights into hospital life. There are packs of generic razors, a table-tennis table and dartboard - even the skeleton of a fourteen-year-old Christmas tree.
"Blake Ward was tidier than Browning Ward and the quieter. Blake patients and staff considered themselves superior to Browning. Browning Ward was a nightmare. The doctors and nurses tried to sedate the ward to keep it peaceful and quiet like Blake Ward, but it didn't work. Like other hospitals, the nurses would advise changes in medication, usually an increase, which the doctor would prescribe without consulting the patient, so the first a patient would know of it would be when they handed their new dose at medication time. Patients who showed the slightest signs of not being medication compliant were written up for an injection. If they refused the injection the nurse would be on the phone to the other wards to round up enough nurses to hold the patient down while the injection was administered." **
"The nurse would give patients medication then make the rounds of the wards at intervals during the night, in charge of over 100 patients Faraday being a larger ward than Guy or Ferrier. The lack of staff continued into the eighties. In October 1982 the Bromley Health Authority’s financial deficit meant that no vacancies could be filled at Cane Hill. Wards usually open were locked during the day. There was no more money for redecorating the wards. Management inspections found damp on some wards. Blake Ward, once the envy of Browning Ward, was described as deplorable." **
On the walls, notices still cling to pinboards. One announced the closure of the Patient Bank, while another laid out a schedule for the last inhabitants (each activity focused on reintegration into the community). Monday, for instance, involved the following routine:
0900 - 1000 - Exercises with Physio
1000 - 1100 - Basic Skills
1100 - 1200 - Current Affairs
1400 - 1500 - Basic Skills
1500 - 1600 - Bingo Session (Social Afternoon)
...and activities for the rest of the month included beauty care, cookery, horticulture, and community outings twice a week. Other notices concerned drop-in centres, rehabilitation schemes such as "Positive Futures", and even opening hours for the hospital canteen.
"Meals were sent from the kitchens in large heated trolleys pushed by patients up and down the corridors from the kitchens. On a good day breakfast would be bacon and beans, or bacon and tinned tomatoes. Other days they would send scrambled eggs made from powdered egg on its own without toast. White bread was provided on the ward as was cereal, Corn Flakes and Rice Crispies. Dinners were the best meal of the day, they were somewhere in between prison food and school dinners. Meat in gravy, mashed potatoes, boiled green vegetable, followed by tinned pears and custard or fruit pie. ...In the evening, supper, which was often paste sandwiches or if you were lucky a piece of boiled fish was served at 5.30pm half an hour after medication or tablet time." **
[In each section of the asylum - but particularly here - there was an almost unbearable sense of waste. The intricate carving of a water pipe, a hand-painted fresco on the wall of a day room. Like the space behind bookcases, it can drive you insane if you accord it any thought. I’m sure that my urge to take photographs is partly an attempt at reclamation – shoring up a defence against obsolescence. As much as celebrating their past, it is an attempt to confer on these buildings, however misguidedly, some kind of permanence (and, by extension, to lend my movements, so often devoid of meaning and connection, some kind of significance or purpose).
"At Cane Hill the corridors smelt of tobacco and cats, (there were over 200 cats living in the hospital). The strong prison issue hand rolling tobacco had the most pervasive smell. Smoke hung like mist in the corridors. The tobacco scroungers started at dawn, on their own or as part of small marauding teams who would wander from ward to ward often told to clear off as soon as they appeared at the door to a ward day room by patients. One patient read the papers, watched the news, and memorised a few details of any disaster reported which he would repeat as a begging routine." **
The hospital pharmacy was also surprisingly well preserved – bottles and cabinets unbroken, boxes unopened. Surplus medication has long since been removed, but much of its packaging remained on site. Containers for anti-psychotics were scattered across the floor, as were containers for emergency drugs, each with an inventory on its lid. With everything from adrenaline to Lignocaine, they offered more than enough to subdue a manic patient, or to assist with crises such as heart failure. (In amongst this mess, there were also some amusing traces of former staff – particularly the Largactil tin that had been converted into a vessel for tea bags)
As with any asylum there was the sense of finality [endgame] – of traversing the outer reaches of suffering and endurance. The nurses may have been kind, the grounds beautiful – but these buildings still represent life at its most attenuated and fragile. It is often people without exposure to their inner workings who feel the most affection for these asylums. Certainly anyone who has endured the blistering immediacy of acute wards, or the desolation of an underfunded geriatric unit, would struggle to feel sentimental about such institutions..
"Phone call from mother to say that Mark was at home causing havoc - smoking cannabis and slapping his mother, also upsetting his grandparents. Urine specimen sent down to the path labs for drug screening. ........Returned to the ward at 3:30pm. Seen by ward staff, he was asked about his behaviour, about causing problems at home and with his grandparents, as apparently he’d taken [patient name] with him. Admitted to taking cannabis, also saying he’d taken money from the bank. To be discussed with Dr. Bernadt tomorrow."
Stripped of people and their everyday detritus, even the most mundane of objects achieved a kind of monumentalism. This was most evident in what would once have been the hub of the asylum – the laundry. Huge cylinders and pressing mechanisms were now adrift in a sea of concrete, while on the east wall a vast extractor fan lay silent above the exit.
"...Peter had been a soldier in world war two, one of the Poles who ended up living in the English psychiatric wards. During the war Peter had tried to end his life by throwing himself under a train but had survived the attempt only to lose an arm and a leg in the process. In his wheelchair Peter would sit just outside the art room door, in front of an easel. On a piece of newsprint, he would draw the same picture, a simple house, a common theme for psychiatric cases, in coloured pencil. Doubtless many of Peter's drawings were burnt in the incinerator that was kept in the courtyard outside the art room. Every year Mrs Croney would burn most of the patients work to make more space in the drawers of the cabinet - in the small store room next to the art therapy room - for the next year’s work of the patients." **
"And my brother lays upon the rocks,
He could be dead, he could be not,
He could be you.."
Given its proximity to London, it's hardly surprising that Cane Hill has a long history of treating famous patients and their families. Charlie Chaplin’s mother, for instance, was interred there (during the psychotic stage of syphilis), as were the siblings of David Bowie and Michael Caine. All three of these cases were particularly tragic - though perhaps the most harrowing was that of David Bowie’s half-brother, Terry Burns, who was older than David by around ten years. A paranoid schizophrenic, he spent much of his adult life in Cane Hill, his illness worsening significantly in his late twenties. On one occasion, while walking home from a concert with a nineteen-year-old Bowie, he suffered a severe seizure and collapsed to the ground...
"I remember we were walking home and it was as though he was having a vision. He saw the roads opening up and fire in the cracks in the road - and he went down on to his all fours and was trying to hold the road, saying he was being sucked up into the skies from the earth .…I had never seen anybody in that kind of metaphysical change before and it scared me an awful lot.. and then of course he went into hospital." **
Given his family connections, more is known of Terry Burns than most other patients - meticulous Bowie biographers and disenchanted family members providing key details about his life. It appears he served, for a time, in the Royal Air Force, and at one stage even married a woman called Olga, a fellow patient from Cane Hill. Staff from the hospital also recall him walking happily around Blake and Ruskin wards singing, as well as spending time in the art department and occupational therapy. The greatest insight into his life, however, comes from David Beales, who was a patient on the same wards as Terry, and would later write about his time at Cane Hill in his memoir The Road to the Asylum.
"Terry's identity was common knowledge. At the time Terry was on Blake Ward, an admission ward. I was on Browning Ward, the other admission ward, which was upstairs from Blake, so we ate in the same dining area. …He had been pointed out to me by a nurse who was happy to identify him. I was warned that he could be aggressive and not to approach him when he had been drinking. ...His wife, herself not well, had sent Terry back to Cane Hill.
’I like to have at least one beer a day - it’s a point of pride,’ he told me. He would pace up and down the ward saying 'This is hell, boys, this is hell.' Another thing he would say again and again was: 'I don't understand why nobody visits me,' and 'I don't know why my family doesn't visit me'. Then, unaware that he was answering his own question, he would say: 'If my brother walked in right now, I'd punch him in the face'. **
Unfortunately, Terry’s time in hospital appears to have followed a familiar downward trajectory: violence, declining physical health, clashes with doctors, mistreatment – and a succession of deepening personal crises. Towards the mid-80s, his suicide attempts became ever more frequent. On one occasion, in December 1984, he lay down on the nearby railway tracks, rolling away from the oncoming train at the last moment before swallowing handfuls of stolen sleeping pills. When approached by frantic railway workers, who had observed the whole scene in horror, he claimed to be waiting for his brother.
"At Cane Hill any violent patient, provoked or not, was automatically sent to a locked ward. Men were sent to Ruskin, women to Cruden. Dr Smedberg referred Terry to the notorious Ruskin Ward..and Terry spent three months there. Terry told me that he was greeted on Ruskin ward by Roy the charge nurse and his staff nurse side-kick, Colin, a Scottish male nurse with a ginger beard and mean disposition. Terry said that these two were a double act and that their party piece involved Colin holding down the new admission to the ward while Roy gave the patient a good kick in the eye." **
Staff who remember Terry around this time describe a limping, overweight figure, his arm withered and teeth blackened, his hands clenched and nicotine-stained. He seems also to have suffered from tardive dyskinesia - a severe side-effect of his anti-psychotics, which resulted in a writhing tongue and body.
"Terry told me that he did not think the tablets did anything. They did not stop the voices. I was with him when he was on medication but still hearing voices. It seems to me that he was unnecessarily prescribed anti-psychotics in an attempt to control his behaviour. ..Though Dr Smedburg thought he was incurable, he was capable of change. ..In fact, the medication was causing him unnecessary suffering." **
After countless attempts, Terry finally committed suicide in January 1985 - precipitated, it seems, by the early discharge of a fellow patient with whom he was in love. In the midst of a heavy snowstorm, he scaled a wall, walked down the hill to Coulsdon South station, and placed his head on the rails, looking in the opposite direction to the onrushing train.
"Terry was in despair and before he died told his Aunt Pat he could not face another year in the hospital. ...[He] would have been helped by a psychologist or by attending group therapy. He was at ease in company and had no trouble speaking his mind. He was coherent, articulate, practical and down to earth. But there was only one psychologist in the hospital and she was working with patients on Salter Ward, the secure ward. " **
Bowie once said of his brother that "Terry probably gave me the greatest education, serviceable education, I could ever have had," adding later that "Yes, it was Terry who started everything for me. ..I mean he just introduced me to the outside things. ..people like John Coltrane which is way above my head, but I saw the magic, I caught the enthusiasm for it because of his enthusiasm. I wanted to be kind of like him. His mind was open to anything.”
Despite drifting apart in the early 70s, Bowie would allude several times to his brother in his work (never directly, of course, but through doubles, shadows and other conceits) - most obviously in 'The Bewlay Brothers', 'All The Madmen' and 'Jump They Say' - and, of course, by featuring Cane Hill itself on the American cover of The Man Who Sold The World. When Terry threw himself from a Cane Hill window in 1982, a gift-laden Bowie visited him in Mayday Hospital, and would later send flowers to his funeral too (failing to attend only because of the circus that would inevitably follow.
There is an astonishing photo of the pair that captures perfectly their different trajectories: Bowie sunglass-clad and mobile, his gaze trained forward; Terry, hunched and inert, like a migratory statue (the two of them utterly at odds with the postcard racks and elderly women behind them).
I wonder, sometimes, if any of his work was among the thousands of drawings and paintings abandoned in the Art Therapy department. There were certainly many pieces from that period; and given Terry's interests, it seems entirely plausible that some of his work survived (though Bowie suggested later that Terry had limited ambitions in this regard, wondering, in a 1992 interview, “how Terry’s life would have changed if he were, by nature, artistic - if it would have released some of the demons...”).
Bowie himself had a particular love of Art Brut (or Outsider Art) - visiting the art department at Gegging Hospital, and the Collection de L'Art Brut in Lausanne, near his Swiss home - and would no doubt have been fascinated by the range of work in evidence.
"In the art room itself there were patients who had attended for years. Mr Evans was an elderly man who sat engrossed in his work. He would divide a piece of sugar paper into 20 squares and spent literally months colouring them in building up a thick layer of crayon in each box. Mrs Croney told me he completed four such pictures a year, three of which she destroyed.
...Frenny would make crayon drawings in a matter of minutes. Frenny was another of the Polish patients who were transported to England for their own safety after the Second World War. She was thin, grubby and had short untidy hair and wore garish make up. Mrs Croney described her pictures as looking like declarations of war, which was not surprising as Frenny was a Holocaust survivor. Frenny was in a permanent state of shock and wandered around the art room asking for cigarettes in her shrill voice with a heavy Polish accent. ’Have you got a cigarette, Johnny?’. We were told not to give her cigarettes by Mrs Croney who held Frenny’s cigarettes for her. " **
In one room, I found myself knee-deep in paper, artwork spilling out from the cabinets above and covering every last inch of floor; (On each visit, a new was layer revealed, explorers helping themselves to countless souvenirs in the intervening weeks). Although some of the work was banal or imitative, most of it bore the hallmarks of outsider art in its purest form - particularly the lack of embarrassment, artifice or self-consciousness. With so many pieces there was the sense of art pared back to pure instinct and need - work produced by people without any conception of themselves as artists. (Art as a kind of silent haemorrhage or exhalation). The quality of each piece was almost irrelevant. Bold geometric patterns, glorious bursts of colour; each a reminder of the consolations and necessity of even the simplest forms of expression.
With almost all destined for landfill, I wish I'd been more meticulous in documenting this artwork, or that I'd taken some pieces home with me. I found myself wary of being caught by security - chastened by countless tales of explorers being prosecuted for carrying a lightbulb or medicine bottle - though I now regret my cowardice. These works are rare instances of patient voice, representing hours or days of intense work, and deserved preservation in some form or other.
Patient poem unearthed in Art Therapy:
Epitaph for Happiness (and Audrey)
There’s not one curse or evil deed,
No spells or promises to heed,
There is no equal power within the mind,
Love’s happiness was hard to find.
"On the admission wards life was pandemonium. Criminals sent by the courts for psychiatric reports were put on admission.... Other patients included the middle-aged patients with their depression and agoraphobia, the manic depressives in manic phase, the schizophrenic mid episode, the suicidal, the alcoholic, and the drug casualties.
If you proved yourself on the admission ward you still had a chance of being discharged back into the community. The nurses were watching you whether you were paranoid or not. Here you might be sitting in the day room befriending a self-harmer or psychotic under the watchful eye of a charge nurse who had the power to recommend an increase in psychiatric medication to a doctor who invariably would take the nurse's word over yours. On the nurses’ advice you could gain your freedom or be consigned to the back wards, the long stay wards. Movement of patients to the long stay wards was usually one way.." **
Hannah Chaplin (1865-1928) c.1885
One day while Sydney was playing football, two nurses called him out of the game and told him that Mother had gone insane and had been sent to Cane Hill lunatic asylum. When Sydney heard the news he showed no reaction but went back and continued playing football. But after the game he stole away by himself and wept. When he told me I could not believe it. I did not cry, but a baffling despair came over me. Why had she done this? Mother, so light-hearted and gay, how could she go insane? Vaguely I felt that she had deliberately escaped from her mind and had deserted us. In my despair, I had visions of her looking pathetically at me, drifting away into a void.
During rehearsals Sydney and I went to Cane Hill to see Mother. At first the nurses told us she could not be seen as she was not well that day. They took Sydney aside out of my hearing, but I heard him say: 'No, I don't think he would.' Then turning to me sadly: 'You don't want to see Mother in a padded room?' ....'No, no! I couldn't bear it!' I said, recoiling. ...But Sydney saw her and Mother recognised him and became rational. A few minutes later a nurse told me that Mother was well enough, if I wished to see her, and we sat together in her padded room. Before leaving she took me aside and whispered forlornly: 'Don't lose your way because they might keep you here.' .....She remained eighteen months at Cane Hill before regaining her health.
The news of Mother's relapse came like a stab in the heart. We never knew the details. We received only a curt official notice that she had been found wandering and incoherent in the streets. There was nothing we could do but accept poor Mother's fate. She never again recovered her mind completely. For several years she languished in Cane Hill asylum until we could afford to put her in a private one.
Charles Chaplin, My Autobiography (London, 1964)
Hannah Chaplin c.1930
The hospital also seems to have its own band of guardians – a silent few who return sporadically to repair damage and ensure order is maintained. Graffiti has regularly been removed from the chapel – although the most famous incident remains that of the bookcase and greeting cards (a tale relayed by the first major chronicler of the site). In one particular room he discovered a bookcase, each shelf home to a row of perfectly aligned Christmas cards. One evening, out of curiosity, he decided to turn down several of these cards, only to return a day later to discover each of the cards returned to its original position. Similar stories abound – and while most are surely apocryphal, such accounts are too frequent in number to be dismissed completely. In amongst the vandals, explorers, freaks and security guards, there are clearly people who care a great deal about the hospital.
"The hospital church [was] a meeting place and refuge for the unemployed poor of the hospital when they could not afford the cup of tea or loose cigarettes in the hospital shop that entitled them to sit on a chair in the shop. The air was not only warm and smoky, but it also smelt of cats. So many cats had made their home in the hospital, that summer a woman from a cat charity was called in to not only to count the animals but to take animals away to be operated on so they could not have kittens. There were cats on every ward, 2 or 3 hundred in the hospital was the estimate, it was impossible to count them all. "Don’t feed the cats!" the patients were told, and so saucers of milk appeared everywhere." **
"Terry explained to me what was happening: ‘Some of these old boys are on two pounds a week, that’s all they’re allowed, and some of them get nothing, because the social security say that they have all their needs taken care of by the hospital. Every lunch time Pat gives me a packet of cigarettes to hand out to them. It breaks my heart to see them picking up dog ends in the corridors’.
It was a sad sight to witness the elderly patients patrolling the corridors looking constantly at the floor, in their worn out suits, with their battered old tobacco tins at the ready. Sometimes two patients would spot an end almost simultaneously and then it was a matter of who picked it up first, leaving the other muttering bitterly." **
Unsurprisingly, of course, the hospital has also been a magnet for thieves, their targets ranging from a few pieces of cutlery to enormous porcelain baths. Tiles on the roofs have also been removed, while copper has been stripped from all accessible wiring. Even the fuel from the one of the boiler rooms has started to be siphoned off. Elsewhere, there are signs of Satanic rituals and paganism (in most cases sheer bravado – but sometimes alarmingly well-informed) – and many doorways are bedecked in blue police tape.
"At mealtime on Blake Ward one wheelchair bound patient caught my attention. Young and apparently chronically intoxicated, she would drift in and out of consciousness. Once I saw her fall face first into her dinner ashamed questioning eyes looked up. As she tried to feed herself, she would spill more and more food over her face and clothes the nurses left her to it and when everyone had left fed her a few mouthfuls and cleaned her up. I asked two nurses on separate occasions what was wrong with her. 'She fell out of a window,' said one nurse; 'A barbiturate overdose,' said another." **
Yet another area in which Cane Hill surpasses all others is paperwork. Most is routine hospital fare - guidelines and government directives – but there are still numerous personal items on display. In the office of one ward, for instance, the desks and floor were littered with case notes. Many of the lives they captured were extraordinary – all the more so for the grand sweep of their narrative, and the taut, unsentimental prose of the consultants. It was incredibly humbling to see someone’s entire life laid out before you - a childhood covered by a sentence, an assault barely stretching beyond a single clause.
"The patient is one of three spinsters, all sisters, who live in the upper part of their married brother's house. They moved there about six years ago. The sisters are of rather unusual appearance and look rather like the weird sisters from a stage set of 'Macbeth'. They were extremely suspicious and reluctant initially to be interviewed but eventually opened up when given an opportunity to vent their feelings about the sister. The dominant one of the pair reported that the third sister had always been difficult, surly and inclined to bouts of moodiness in which she won't speak to anyone. Over the past few years she has become increasingly trying. She refuses to walk beyond the house and demands to be be taken anywhere by transport and has in fact only been beyond the house on one or two occasions. During the summer months last year, she would venture downstairs and sit in the garden.
Over the past year or two it seems on several occasions she has complained of feeling generally unwell, becomes languid and floppy and is put to bed. The doctor to whom she has always declined to speak, has never been able to find any physical abnormality. The sisters regard her behaviour as being spitefully motivated - "she's just difficult and lazy", essentially an act of malingering.
It seems that from time to time she is incontinent which further adds to their conviction that she is being deliberately annoying.
She spends her time otherwise just simply sitting about in the chair, doing nothing. She dresses herself, eats and sleeps well. She is very deaf and wears a hearing aid.
She was seen on two occasions by the interviewer, as on the first it was impossible to arrive at a diagnosis. When seen she was in bed and she was having another incident of the type described by the sisters. She smiled and looked at the interviewer and was about to speak when he first entered the room and then appeared to change her mind, and gave the impressions of feigning a posture."
"The most immediate intervention-cum sanction, was the use of extra medication to dampen any disturbed behaviour...In those circumstances where the patient refused the increase, and resisted its administration, it was administered on his or her behalf via an injection in the buttock, having first restrained the patient in what often could descend into a free-for-all scuffle. Invariably dispatched to the seclusion room in an undignified sprawl, the patients underwent the indignity of being stripped of clothing down to their underpants."
Stephen Burrow - Buddleia Dance on the Asylum ***
"Patient is an old Boer War combatant, who after many years service, left the army to become a postman. For the past 38 years he has lived with his niece who has looked after his needs since his wife died (his wife died shortly after the niece came to live in the same household).
Pleasant without being fatuous, but was suffering from general memory failure and scored only 1½ in the orientation test.
Recently he has expressed a desire to go to a nearby pub and has on a few occasions been escorted along the street by neighbours. Apart from this he does not appear to have left the house for years. He is generally unstable on his feet, but is able to manage the stairs.
Although his niece seemed cheerful enough at interview, she often feels downhearted and wonders what there is in life for her. She fully admitted she would be glad when he is dead and asked the interviewer if this would be likely in the near future."
"I was re-admitted to Cane Hill just before Christmas 1980. I was put on Guy Ward, a long stay ward. I attended the Industrial Therapy Unit and slept in the ward dormitory. There were about 30 beds in the dormitory and about 20 patients. I was allowed an afternoon in the art room and was offered an afternoon attending a group therapy session on Salter Ward. ...During one session we heard shouts and the banging of furniture hastily moved out of a side room as a patient was restrained. The television was a popular target for aggression, even though it was housed in a wooden box with a Perspex window due to the frequency of attacks." **
Ward reports were rather more scarce, though the handful I stumbled across offered a fascinating glimpse of life in the hospital - mainly its monotony, of course (by far the most common entry was “nothing to report – all patients appear comfortable at time of writing”), but also its rare flashes of violence and disorder. These reports also offered my first encounter with patients my own age. Many of those listed were in their late teens and early twenties – and I found it impossible to look upon such cases objectively. I’ve somehow found my way out of that world, but most aren’t nearly so fortunate..
"The patient is a pleasant, rather obese widow of 84 who has had a variety of physical illnesses in her life. …More recently, she has become depressed and has even been ruminating about her husband who died suddenly 15 years ago. She has been tearful and recently felt that it would be better if ‘God would take her’, but such feelings have not been voiced to others, and the district nurse was unaware of them. Recently she awoke in the night and saw her husband."
"Besides the poor souls in the hospital shop there was an occasional "hospital hopper" who made a career of moving from hospital to hospital in. search of three square meals a day and a roof over his or her heads. Usually found out by staff and patients they would wear out their welcome boring everyone with their fake symptoms and hard luck stories until they were asked to leave. After a while their descriptions were circulated amongst hospitals in the area and pinned to admission ward staff room walls like wanted posters." **
"Patient welcomed the interviewer and commented on the praiseworthiness of an interest in the welfare of the aged. There was only evidence of mild rateable psychiatric pathology at interview – but it seemed she has been disturbed by the suicide of her grandson, an anaesthetist, about six months ago. The event, of which there was no previous indication, was a great shock to her and her family. She has slept badly, felt dispirited and the event has remained continually in her thoughts.
She felt she had now recovered from it, and had accepted it as divine intervention. She has had a lifelong interest in Spiritualism, and allied subjects, and is inclined to interpret significant events in terms of such beliefs. Her husband, who died several years ago, was a Christian Scientist. She was again upset by his death and grieved for about a year, feeling his presence after death in the house. Her beliefs were well in accordance with the philosophies propounded by members of such associations, and could in no way be regarded as delusional, nor was there any evidence of sinister psychiatric abnormality.
Her garrulous talk was again a quirk of her personality. Apart from being a day out in her orientation, and suggesting that Lloyd George was the Prime Minister before Heath, see seemed well orientated. She seemed throughout mentally alert, cooperated well in the Names Learning Test. She scored only two errors in the first two trials. She tired visibly as the tests proceeded and scored only 46/60
In summary a resolving grief reaction, with the persistence of moderate symptoms of anxiety. Slight memory impairment, but not dementia."
"It was not all grim. The food may have been overcooked but it was at least on time and three times a day. There were films on Wednesday afternoons, pre-war black and white films, ghostly projections on a large old roll down screen, with dated dialogue and classical music soundtrack adding to the eerie effect. There was a percussion band that played on the main stage on Thursdays. A woman played what sounded a bit like slowed down stride music. " **
The hospital may now lie derelict, but it remains very much a part of local consciousness (certainly there is nothing of remotely the same scale within the town’s boundaries). Approaching Coulsdon from the north, its water tower dominates the skyline, while its long driveway begins at the mouth of the town centre. Even when riding the bus from East Croydon, several people mentioned it in passing; and it remains a regular news item in the local press. With each generation, perceptions of the hospital change (it appears that fear has now been supplanted by curiosity); but the hospital retains a prominence greater than in almost any other town…
Viewed from the footpath it still seems incredibly forbidding - yet once inside all unease vanishes. Many asylums have a post-apocalyptic aura - wastelands burdened with signifiers of death and illness – and yet Cane Hill seemed different. Everywhere there were traces of pain and suffering, but the mood was still one of gentle decline. Perhaps it was simply that many of the fixtures and fittings were so antiquated – but the overwhelming feeling was simply of a building whose life had run its course.
"Malcolm would lie on his bed for most of the week missing meals occasionally until it was his social security pay day. Then he would go to the post office in the town and collect his £7.60p and buy tobacco for the week. He would spend the rest on John Smiths bitter eight cans and drink the lot down an alley. Malcolm was on injections and this, along with the missed meals and empty stomach, increased the effect of the beer. Then Malcolm would return to the dormitory and wait for the next pay day.
On the ward if he could be bothered to join in the conversation at all it would not be long before he was accusing someone of being a plainclothes policeman. He would interrupt any conversation you would try and start with the assumption that anyone you happened to mention would turn out to be a plainclothes officer. 'Plainclothes,' he would announce, predicting the upshot. To him there was little point in a conversation that did not end in someone being revealed as plainclothes." **
Arson, too, is sadly a common occurrence – and yet at times I found myself thankful for some of the views it afforded me (inching down blackened corridors before emerging into an almost celestial light). In Vincent Vanburgh, for instance, a fire has caused the building’s entire mid-section to collapse. Light now streams in from three floors, granting an astonishing cross-section of its many cells and days rooms. Floors buckled and bowed, doors charred and fragile - and yet the whole area resembles a firebombed cathedral.
It is only such, of course, because firemen prevented the rest of the hospital from becoming an inferno - but it is still impossible to deny its splendour, or to deny the creative power of destruction. Indeed, the entire area provokes such awe, it seems hypocritical to condemn those responsible.
"Relatives that could not cope with the mentally ill patients at home expected the mental health service to look after them in the hospitals, while the hospitals were desperately understaffed. ...The nurses on Guy Ward were not wilfully neglectful. They were good nurses but there were not enough of them. The ward was understaffed. Unlike the admission wards who always had at least three or four nurses on duty during the day and one night nurse for each ward on the long stay wards one nurse was expected to supervise over thirty patients who were either at therapy, roaming the corridors, watching television in the day room, upstairs in the dormitory, in the side rooms that line the hall and landings, in the wash room, visiting other wards, or in the hospital shop." **
Cane Hill remains the ultimate example of the strange life that buildings assume after they’ve been vacated. Arsonists and vandals have left their mark in many sections of the hospital – but such destruction is the work of only a tiny fraction of visitors. The overwhelming majority come only to inspect a magnificent ruin.
Increasingly, I find myself wondering why people visit these buildings - and more significantly, continue to return long after their initial curiosity has been sated. The person who first showed me a way inside (an ingenious unscrewing of a loose slat on the palisade fence) claimed to have visited dozens of times; and I know of several others drawn back to Cane Hill in particular. Indeed, there now exists small group of explorers returning to the site on an almost weekly basis (most with camera in hand). Trolleys are ridden along corridors, machinery clambered into. Often an upper floor is colonised and a small party takes place. In one corridor someone had even affixed a poem to the wall, bizarrely including their contact details at its base.
There are, of course, the more obvious elements - the peacefulness and wildness; the clandestine thrill of being somewhere forbidden or dangerous; the subversion and disorientation; the clear beauty and uniqueness of the spectacle - yet this still does not quite explain the compulsion to revisit. Growing up in the shadow of Warley, psychiatry was the backdrop to my childhood (and later the scourge of my adolescence) – and so former asylums naturally hold a particular fascination for me. When depressed, too, I often grow weary of family or nature, and need to be immersed in something more excoriating and hopeless. Each visit is not so much an embrace of new experience, or a search for some kind of answer, but rather an escape, an almost foetal retreat into the world at its most marginal and redundant.
Perhaps the greatest illustration of my state of mind is the fact that I experience a sense of comfort when wandering about these forgotten asylums. Not exhilaration or awe, but comfort. Their innards ripped out, floors caving in, level after level of support slowly falling away - yet they are still there; from the outside appearing almost unchanged. Indeed, they are such a perfect metaphor as to be laughable.
There is, then, an element of narcissistic projection - finding in the hospital a visual analogue for any despair - but it remains an urge I don't quite understand. As others have suggested, perhaps it also represents a turning away from unbearably oppressive consumerism - the demonic sheen of Starbucks and Bluewater. In antiquated trolleys and crumbling machinery, there is at last the chance to pause or to slow time…
“Dilapidation, derelict London… we love to wander in these little 'Stalker'-like scurf zones of underdevelopment, to escape the crushing sense of Now. Aspiration, hygiene, focus: we want somewhere to flee from this Amerika of the soul. …We don't hunger for the time when these caffs, these ruins and rust-heaps, were shiny-new. We savour their decay, the gentle rot...” - Mark Fisher
(...this comes, of course, from the privileged position of material comfort ; for many people such conditions are their everyday reality, and this nostalgia or swooning must sometime seem baffling or indulgent)
"On the less volatile Guy Ward we had two old school but reasonable nurses running the ward during the day. Joe was a friendly Irish nurse and Jack was an older English nurse. Joe was content with the regime, but Jack occasionally got into his head that we had it too easy. 'They have everything done for them,' the nurse on the next ward down the corridor, Faraday Ward, would say, and Jack would agree - his agreement more irritated if he had lost on the horses which happened a lot. " **
One of the last parts of the hospital I visited was the mortuary, a small building to the rear of the site that even included its own chapel. All that remained were trolleys, weights, and two lustrous porcelain slabs (one of which had been recently cleaned). Closer examination yielded some rather chilling details - drainage channels for blood and fluids, scales for the weighing of body parts – but the atmosphere remained sombre rather than grisly or macabre. As with much of the hospital, its most stark or harrowing features have been softened by nature; the random incursion of brambles and other flora. In an adjacent room there were storage bays for fifteen bodies, each lifted and stowed by an antique rack-and-pinion mechanism, but again, there was very little damage – the supports discoloured only by random patches of mould.
"I don’t remember seeing any abuse of patients, although sometimes the patience of staff could wear a bit thin when patients behaviour was quite extreme. I remember one patient who was very keen to clean up all the time to the extent that she took the other patients plates away while they were still eating – that earned her a bit of a reprimand.
...The physical side of care was quite good – I remember being taken to the dentist, chiropodist and optician while I was there – all in the hospital....There was no psychological input at all. I had expected to get some therapeutic support on a one-to-one basis or in groups, and that didn’t happen at all." - Jan (patient, 1989) *
Pigeon coos merged with the distant rumble of freight trains – but all wildlife at Cane Hill stayed resolutely out of sight - excretions and carcasses their only trace. In most instances, their bodies had decomposed beyond all recognition – although beneath a window in Andrewes, I discovered a still-warm bullfinch - its burnished plumage all the more startling when set against the dampened hues of the walls and curtains).
My grandmother has been ill recently; the last few weeks punctuated by visits to the nearby hospital. Seeing her last night – in a dismal, urine-soaked ward – I began to feel rather depressed, but then suddenly a nurse smiled at me, a patient in the next bed made my grandmother laugh, and I was reminded of the rather simple truth that it is the people who make these places.
Indeed, when it comes to asylums, compared to the testimonies of staff and patients, the buildings themselves are now of limited interest - crumbling relics with only the slightest trace of the people they once held. Almost all of these voices, of course, are now lost or barely recoverable - surviving, most often, in the heavily mediated form of ward reports and case notes - the buildings bearing mute witness to the thousands of lives they shaped so profoundly.
* canehill.org - recollections of Jan come from a section of staff and patient memories within this excellent resource.
** The Road to the Asylum - David Beales (2012) - a wealth of insights into Cane Hill, mental health, and the life of Terry Burns.
*** Buddleia Dance on the Asylum - Stephen Burrow (2010) - insightful account of Cane Hill and the UK's mental health service.
(visit links for many more images and detailed history of the hospital, as well as testimonies of staff and patients)