A ‘desperate state of things’

⚠️ Content warning: This story contains references to suicide, mental illness, and historical psychiatric treatment, which some readers may find distressing. Please take care while reading.

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The revelation

I’ve never forgotten the moment in August 2009 when I opened the envelope which contained the death certificate of my great-grandfather – a man who had never once been mentioned in my family.

I was still fairly new to researching my family history, and this was before digital records were widely available.  You couldn’t simply click and download an image of an entry within minutes.  Instead, it was a more deliberate process:  first identify the index reference; then, fill out an online form, make a payment, and wait.  About a week later a thin A5 envelope would arrive by post, containing a formal Certified Copy from the General Register Office.

These certificates always followed the same format: red ink for birth, green for marriage, and black for death – with the personal detail neatly overprinted in black.

By the time I ordered the certificate, I felt I already knew a fair amount about him: Dr Alexander Cameron Brock, a 42-year-old surgeon and physician living in Dorking, Surrey, with his wife and young family. It had struck me as slightly unusual that his death had been registered in Southwark, London – but I assumed he might have been visiting the city and had perhaps been involved in an accident.

The certificate was folded in half as I pulled it from the envelope.  I glanced at the name:  Alexander Cameron Brock, aged 42, a medical practitioner from The Old House, Dorking.  The date of death was 12^th April 1898 in hospital, though I couldn’t quite make out the name of the institution at first.  My initial reaction was relief: I had ordered the right document.

Then I unfolded the page fully and read the cause of death.  “Haemorrhage of the throat.  Deceased committed suicide by cutting his throat whilst in a state to Temporary Insanity. P.M.”, and I realised the hospital was Bethlem – widely known as ‘Bedlam’ – the world’s oldest psychiatric hospital.  I still remember the exact moment my relief turned into shock.  In that moment I knew that I had to find out more about the events that led to Dr Brock’s death and the impact it might have had on his family.

Looking back, it’s perhaps not surprising that no one in the family ever spoke of my great grandfather, or his illness and terrible death – perhaps they didn’t even know. Mental illness carried enormous stigma well into the 20th century, and suicide was often cloaked in silence or shame.  Even by the 1960s and 70s, public understanding of psychiatric conditions was limited, and few families felt able to speak about them openly.

I saw that silence first-hand.  My mother – Dr Brock’s granddaughter – was hospitalised on numerous occasions during my childhood, diagnosed with what was then called manic depression and schizophrenia. Her illness was rarely acknowledged outside our immediate household, and never explained in terms I could understand.  In a time when mental health care was still dominated by institutionalisation, and phrases like ‘nervous breakdown’ or ‘being put away’ were used to soften the truth, it was easier to say nothing. Tragically, my mother’s own illness would ultimately lead to her too taking her own life, but that’s another story.

Bethlem Hospital

The Priory of St Mary of Bethlehem, founded in Bishopsgate in 1247, became known as ‘Bethlem’ or ‘Bedlam’ – early variants of ‘Bethlehem’.  Originally established as a religious institution, it gradually evolved into a hospital for the ‘insane’, and over the centuries, it came to symbolise the troubled history of mental health care in Britain.

By the 19th century, Bethlem had developed a policy of prioritising acute cases. Admission criteria were strict, and patients who were not considered ‘curable’ were typically discharged after a year.  In 1852, following the departure of visiting physicians, the hospital adopted a progressive policy of non-restraint and moral management, reflecting a broader movement towards more humane psychiatric care.

By the time of Dr Brock’s admission in 1898, the criminally insane had been transferred to Broadmoor – a purpose-built asylum in Berkshire, opened in 1863.  The grim cells and open wards with unglazed barred windows that had once characterised Bethlem had given way to brighter, more domestic surroundings: carpeted wards, potted plants, and pictures on the walls.  Three hundred patients could be cared for, and the new wards featured every modern convenience, including warm air central heating, hot water, and a state-of-the-art electric bell emergency call system.[ii]

Bethlem Hospital still exists today, now known as Bethlem Royal Hospital – a modern psychiatric facility that forms part of the South London and Maudsley NHS Foundation Trust.  The Lambeth building that once housed the hospital in Dr Brock’s time is today the home of the Imperial War Museum, and the hospital Archives and Museum are located in Beckenham, Kent. 

Curious to learn more, I contacted the archivist to ask whether they held any records relating to Dr Brock, and his death in the hospital in 1898.  A few weeks later, a large envelope arrived in the post, filled with black-and-white A3 photocopies that would reveal the last chapter of his life.

I worked my way through these copies, slowly transcribing the spidery handwritten notes.  Fortunately, some of the documents were on pre-printed forms that had been completed by the medical team.

Among the documents sent from the archives was an Urgency Certificate issued by Guy’s Hospital — a required form to certify that Dr Brock was suffering from mental illness and in need of immediate care. The clinical language is stark, but deeply affecting. He was described as lying in bed, saying only, “this is a desperate state of things”, but refusing to explain why. He believed he had wronged his former medical partner. He refused food, was taciturn, and complained that meals were “full of dust” and that he was “ruined”.

Perhaps most chillingly, the certificate recorded that Dr Brock had recently gone out in the early hours and roamed the edge of a cliff, threatening to take his own life.  His brother had successfully talked him down, but reported that he remained in a state of “high tremor and nervous excitement”.  The attending physician concluded: “He urgently wants excessive feeding and he cannot be made to take it voluntarily.  He is so depressed that I fear his doing harm to himself”. In today’s language, Dr Brock had been sectioned – detained under the mental health laws of the time for his own safety and care.

A second document, the formal Statement of Particulars, was signed by his elder brother, the Reverend Henry Walter Brock, a church rector from Guernsey.  The family clearly acted out of concern, hoping for help.  Interestingly, Dr Brock’s listed medical attendant was his former practice partner, Dr Charles W. Chaldecott of Dorking.  Their partnership had recently been dissolved, as Dr Brock had been unable to practise for several months.  This too is revealing – not just of his mental decline, but of the professional and financial pressures he may have been under.  The third document in the set was an Urgency Order, formally signed by his brother, authorising his immediate admission to Bethlem Hospital.

Who was Dr Brock? 

Alexander Cameron Brock was born on 7^th June 1855 in the Rectory of St Pierre-du-Bois, a small village in Guernsey, one of the Channel Islands.   He was the third son and fifth child of Carey Brock, the rector of the parish and later Dean of Guernsey, and his wife Frances Elizabeth Georgina (née Baynes), the author of a series of popular religious books and allegorical novels written under the name Mrs Carey Brock. 

Educated at Elizabeth College in Guernsey, he went on to study medicine at Guy’s Hospital in London, qualifying in 1877 as a Member of the Royal College of Surgeons (MRCS) and Licentiate of the Royal College of Physicians (LRCS).[iv] Ironically, it was the same hospital where he would be admitted twenty years later, not as a student, but as a patient in crisis.

His first medical post was as a physician’s assistant at Bristol General Hospital, where he quickly advanced to assistant house-surgeon.  During his time there, he gave evidence in several brutal assault cases heard at the Bristol Police Court – early experience that must have brought him fact to face with trauma and violence.[v]

After gaining valuable clinical experience in Bristol, Dr Brock relocated to Dorking, Surrey.  His eldest brother was then serving as curate of St Martin’s Church, and two of his sisters had also settled in the area.

It was in Dorking that he his future wife, a young American orphan, Elizabeth Brevoort Coolidge.  They were married quietly by Dr Brock’s father, now Dean of Guernsey.

Ten months after their wedding, a brief notice appeared in several newspapers announcing the birth of their stillborn son.  A healthy son – later my grandfather – was born two years later in September 1883, followed by a daughter, Cécile, in August 1885.  Looking back through the records, there are small hints that something wasn’t quite right.  Although both births were announced in the newspapers in Surrey and Guernsey, and both children were baptised promptly, Dr Brock failed to register either birth within the legal time limit required by law.[vii] [viii]

The pressures on Dr Brock in the years leading up to his collapse were, in hindsight, immense.

In December 1888, his daughter Cécile, now three, fell seriously ill and was taken to the home of his senior partner, Dr Chaldecott, for treatment.  Despite their best efforts, she died of whooping cough and tubercular meningitis – infections that, today, are both preventable and treatable.  Dr Brock himself was the attending physician and certified the death, and her mother registered little Cécile’s death three days later.[ix]  

Just two months later, in February 1889, Lil gave birth to another daughter, Lilian.  The trauma of fresh grief, overlaid with the demands of a newborn, must have been considerable.  Yet outwardly, life went on.  Over the next four years, the family grew again: Constance (known as Sissie) was born in 1891, followed by Helen in 1893.  The Brocks moved to The Old House on South Street – a handsome, now Grade II listed home – where they employed a cook, housemaid, and nurse: an image of secure, respectable, middle-class life.

But behind that façade, cracks were beginning to show. Dr Brock had long suffered from dyspepsia, but by early 1897, his condition was worsening. He began refusing food, sleeping poorly, and growing increasingly withdrawn and despondent. Although he still appeared at local civic events, the confident, sociable doctor was beginning to fade.

On 6^th May 1897, Lil gave birth to another child – a stillborn son.  It was the couple’s second such loss.  A short, matter-of-fact notice appeared in a Guernsey newspaper,[x] offering no hint of the tragedy quietly unfolding in the household.

It was all too much

Within weeks, Dr Brock’s condition had deteriorated to the point of threatening suicide.  He was taken by his brother to Guy’s Hospital, then transferred to Bethlem for an initial three months’ emergency stay.  The case notes from Bethlem, compiled on his admission on 5^th August 1897, offer a haunting glimpse into the decline that had begun more than a year earlier.  From family reports, his personality before illness was described simply: “bright and cheerful, sensitive, retiring.”  These few words sketch a man who was gentle, introverted, and conscientious – a far cry from the broken figure who arrived at the asylum.

By that point, he had been more or less sleepless for twelve months. The crisis appeared to begin in April 1897, when he developed a painful eye condition known then as rheumatoid iritis.  Around the same time, he began eating very little and grew physically weak and easily fatigued.   

By June, he was talking openly of suicide. By July, the threats became more urgent, he was expressing delusional fears about bowel obstruction and financial ruin, and had attempted to take his own life.

When admitted to Bethlem from Guy’s Hospital in early August, he was in a terrible state.  He had developed a total refusal of food, and his body was wasted. On admission, he weighed just seven stone.

The admitting doctor described a middle-aged man who was “very emaciated, very depressed and melancholy”.  He was reluctant to speak, though he expressed vague ideas of being “ruined and lost”, and was fixated on the idea that his body no longer assimilated food.  He insisted he had been eating “quite enough”, although it was clear he had been starving himself for some time

The diagnosis was recorded as “Mela (Hypoch)”, likely shorthand for hypochondriacal melancholia – a form of depression marked by bodily delusions and extreme despair. The stated cause of his illness was simply “worry”. The prognosis, somewhat hopefully, was marked as “good”.

During his first three months in hospital, Dr Brock was regularly force-fed by a tube, sometimes up to four times a day.  His progress was erratic.  The records show that his stay was extended twice and, although he remained under 24-hour observation, his wife Lil was allowed to visit once a week. By 8th April 1898 it was noted that he was a little brighter, taking food well, and passing the time reading. 

Four days later he was dead.

Aftermath

The subsequent inquest recorded a verdict of “Suicide during temporary insanity and no remissness on the part of the hospital authorities”.

For years I searched in vain for Dr Brock’s burial place, visiting several cemeteries without success.   I even travelled to the family church at St Pierre du Bois in Guernsey.  Although his name appears on the reverse of a family memorial, I assumed – given the circumstances – that he had not been buried there.

More recently, newly available records from the Bailiwick of Guernsey, including the parish records from St Pierre du Bois, were added to the FindMyPast website.  These confirmed, beyond doubt, that the family had quietly arranged for his body to be returned to Guernsey.  He was buried the day after the inquest. 

There’s a poignant paradox in this.  Suicide was traditionally viewed as a grave sin in Christian theology, especially within the Church of England.  Taking one’s life was considered self-murder, a violation of the commandment “Thou shalt not kill.”  However, if the deceased was judged to have been insane at the time of death – as Dr Brock was – burial in consecrated ground was permitted.  Even so, it’s telling that the funeral was not performed by Dr Brock’s brother Henry Walter, who had succeeded their father as Rector of the parish, but by the vicar of the neighbouring parish of Cobo.

I’ve never seen a photograph of my great-grandfather, Dr Alexander Cameron Brock.  But from what I’ve learned, I believe he was a deeply kind and compassionate man who, despite his medical training and professional experience, was overwhelmed by self-doubt and grief following the death of his daughter and two stillborn sons.

Men of his class and generation were expected to remain stoic – to stay strong and suppress their emotions.  But mental illness is no respecter of gender, status, or education. Then, as now, it can touch anyone.  The difference is that today we speak more openly about mental health, and with greater understanding.  The shame and silence that surrounded people like Dr Brock is slowly giving way to compassion and acceptance.

I’m proud to have been able to uncover my great grandfather’s story – and deeply sad that he was forgotten for so long.  I welcome him now, quietly and respectfully, back into the family where he belongs.

Click here to read this story from Dr Brock’s wife Lil’s point of view including the discovery of his death, the inquest, and what came after.

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