Psychiatric treatments

Julia Bueno’s review of Desperate Remedies by Andrew Scull (April 22) was an excellent discussion of the subject of egregious excesses in the treatment of people with behavioral problems. I would only add to one part of her piece. She mentions the lobotomy on a patient called Alice Hammatt in the USA in 1936. These surgeons were following the action and publication of the renowned Portuguese neurologist Egas Moniz and his colleague, the neurosurgeon Almeida Lima, who lobotomized patients in Lisbon to treat intransigent obsessive behavior . The first intentional human lobotomy had occurred in Switzerland under the supervision of the medical superintendent of a mental asylum, Gottlieb Burckhardt, in the 1880s. The rationale for these efforts at treatment was the celebrated accident of Phineas Gage in 1848. This US railway worker survived his skull being transfixed by a tamping iron, which gave him an involuntary lobotomy. It is recorded that his behavior and personality changed after the accident and this was studied by medical practitioners and reported, in detail, to the Boston Society for Medical Improvement in 1849. These findings were the evidential basis for the neurosurgeons’ and psychiatrists’ later actions . Moniz’s advocation of the procedure made the treatment internationally popular with practitioners and gained him a Nobel prize in 1949. It was still a frequently performed operation in UK mental hospitals in the 1950s. I grew up in the grounds of such a hospital at that time and I remember some of the patients.

Robin Havard Davies
Tregarth, Gwynedd

As clinical psychiatrists and psychiatric educators we dispute the portrayal of psychiatry in Julia Bueno’s review of Andrew Scull’s Desperate Remedies. His book and her appraisal of it are not connected at all to the anguish and suffering from psychiatric illness that prompted such remedies. During 2020, three million American adults had schizophrenia, a disease associated with poverty, incarceration, hospitalization and unemployment. Fifty thousand suicides were associated with schizophrenia in 2018. The UK had comparable per capita statistics. This devastating disease produces delusions, hallucinations and an altered sense of self, a picture unrelated to the outdated Hollywood version of psychoanalysis from Hitchcock’s movieSpellbound (1945), used to illustrate the review.

Much of the focus of this review was equally outdated. For instance, transorbital lobotomy treatment for this disease ended in the mid-1950s. This discarded approach was invented during a medical era that predated the development of efficacious antibiotic drugs. Lobotomy was replaced long ago by anti-psychotic agents, and we now possess both psychiatric medications and psychotherapy as well-validated treatments for all major mental illnesses. Bueno’s reference to contemporary cutting-edge treatments such as psychedelic agents for depression is welcome, but ignores an array of established treatments that are scandalously underfunded, but otherwise widely available. Progress in psychiatry is frequently overlooked because it has been slow and fitful. But the human brain, with its 86 billion neurons, is unlike organs such as the kidney, with its two million nephrons, and Bueno’s comments betrayed little appreciation for the challenges of this unimaginable complexity.

Peter Barglow
University of California Davis, Berkeley CA

Sidney Weissman
Northwestern University, Evanston IL

Daniel Morehead
Tufts Medical Center, Boston MA

Thomas Piketty

In her review of Thomas Piketty’s A Brief History of Equality (May 6), Deirdre Nansen McCloskey writes: “The most salient feature of Piketty’s obsession with the redivision of the social pie is that he never mentions the enormous increase in the per person size of the pie since 1800, 1900 or 1960. Pas une fois“. In fact, that’s the subject of Figure 2 on p19, and of adjacent text.

Ian Malcolm
Chipping Norton, Oxfordshire

Russia’s nuclear weapons

Henrietta Wilson writes (April 29) that Soviet nuclear weapons were “repatriated” to Russia at the end of the Cold War. But the Soviet Union and Russia were, and are, different countries. Moreover, article 1 of the Non-Proliferation Treaty stipulates: “Each nuclear-weapon State Party to the Treaty undertakes not to transfer to any recipient whatsoever nuclear weapons or other nuclear explosive devices or control over such weapons or devices directly, or indirectly” (my emphasis). After 1991 there should simply have been one less nuclear-weapon state in the world and on the UN Security Council. It was the election of Boris Yeltsin, and the craven acceptance of his actions by other Security Council members, that led ultimately to the destructive results for democracy and international peace that we are now witnessing in Ukraine. Having been expelled from Gorbachev’s Politburo, Yeltsin succeeded in being elected for the new post of Russian president, thereby seizing the command and control, in Moscow, of former Soviet nuclear weapons. This in the end was a formal action, a transfer of power, on December 25, 1991, as recorded by Gorbachev in his memoirs. Yeltsin proceeded to the dismemberment of the Soviet Union at Belovezhskaya Pushcha in Belarus, where provision was made for the (inoperative) former Soviet weapons in Ukraine and Belarus to be “returned” to Russia. But not before Yeltsin had run to the UN Security Council – warning histologically, and entirely hypocritically, of nuclear chaos if the weapons were to be “dispersed” out of his own hands – in order to press his case for recognition of Russia as successor state to the USSR, with all “former Soviet rights and privileges”. That was the first act of Russian nuclear blackmail. Vladimir Putin was Yeltsin’s last prime minister and decided successor. The self-serving, deterrence-based hierarchy of the UN Security Council must be dismantled, just as nuclear arsenals had begun to be under the Reagan/Gorbachev treaties (INF and START), before Putin embarked on his nefarious work as Russian president.

Peter Lomas
Balmullo, St Andrews, Fife

Lindley Murray

I was interested to read Lynne Murphy’s comment in her review of Bryan A. Garner’s Taming the Tongue (April 29) that Garner “enjoys imagining that Lindley [Murray] got wind of the fact that his buyer [Noah Webster] was writing a grammar and that it inspired him to try writing one himself”. She points out that Murray’s grammar was published within the year, giving this as a reason that she finds Garner’s suggestion “difficult to swallow”, though “entertaining”.

I am able to offer cogent reasons for not swallowing Garner’s imaginings. The history of The Mount School, York (still a Quaker school for girls, of which I was head from 1986 to 2000) records that the Pennsylvanian Quakers Lindley Murray and his wife came to England in 1784 and, soon after arriving in York (something of a Quaker stronghold), bought a house not far from the school.

Murray’s poor health necessitated a sedentary life. Besides his personal scholarly pursuits, he took great interest in the school and was often consulted as its “literary oracle”. Three teachers turned to him for grammar lessons, and soon afterwards sent him a humorously exaggerated but undoubtedly genuine request that he should write a grammar for use with students. They spoke of the “incomparable abilities of their able preceptor”, humbly soliciting that he should prepare “materials for a work so important; in the execution of which they will gladly afford him their feeble assistance.” They go on to hope that his “labours may be amply rewarded by … its utility to … succeeding generations”, a hope more than fulfilled by his grammar‘s continuing to be the key book on the subject for over a century.

The school history also includes Murray’s reply, expressing his modest reluctance that one so “incompetent” as he should undertake this task, but his willingness to do so, once he has checked that the national Quaker body does not already have someone else in mind. With these provisos, he “purposes … to comply with your desires, in which I shall be certain of the satisfaction of having endeavoured to please and accommodate those who have so much of the love and esteem of their sincerely attached friend Lindley Murray.” Visitors to – and all members of – The Mount School still enjoy the elegance and utility of the summer house that used to stand in Murray’s garden.

Barbara Windle
Dunnington, York

Poets of colour

Dominic Leonard’s review of Stephanie Sy-Quia’s Amnion (April 8) provoked her friends and mentors at Ledbury Poetry Critics to gather signatories for a letter (April 29). Dr Howe, Dr Parmar and Dr Ravinthiran emphasize the importance of framing. Their own framing would us to view Leonard as a white man displaying unconscious bias, inexperienced in the legacies of post-lyric writing by minoritized poets, dangerously close to being encouraged sexist, and leading us to a prejudiced encounter with the text. Grave charges indeed. If Leonard remains inexperienced and prejudiced despite an MA in Postcolonial Literary and Cultural Studies and admiration for experimental writers of color such as Bhanu Kapil and Vahni (Anthony) Capildeo – who I note is a signatory – what sort of experience a reviewer must read Sy-Quia’s book? Perhaps the TLS Should only match the text to her associates in poetry – a professor of poetry at Liverpool University, or King’s College, or Harvard, for example? Perhaps, instead of an MA, one needs a doctorate before reading Amnionand the book isn’t for the general literary reader at all.

Or perhaps TLS Readers can see the open letter for what it is: an entirely spurious complaint against the editors and reviewer for daring to publish a bad review of one of the stars of their emerging critics’ scheme. I’m sure Sy-Quia’s reputation will survive the 300-word blow. I’m not sure the Ledbury Poetry Critics’ reputation will. They seem to assert that writers of color need specialist reviewers, specialist readers and their own particular brand of special pleading. Thankfully their scheme hasn’t recruited and neutered all the critics of the land (yet) and, until it does, they will have to bear the disappointment of the occasional unvarnished review.

K. Choudhry
London E7

Picasso and friends

It’s nice that James Fenton knew these various famous people and has little anecdotes about them (May 6), but were the books and the exhibition he was supposed to be reviewing any good?

Mark Callan
North Shields, Tyne and Wear

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