DR HENRY RAPOPORT ROLLIN
1911-2014

Psychiatrist, author and Deputy Superintendent of Horton Mental Hospital 1948-75/6


DR HENRY RAPOPORT ROLLIN
Dr Henry Rollin.
Portrait by Jacob Kramer 1952
Image courtesy of Bourne Hall Museum

Background and early career

Henry Rapoport Rollin was the son of Aaron Rapoport (1885-1972), who later added the surname of Rollin, and Barbara Sorkin. Accounts vary as to whether Aaron came from Lithuania or Latvia but, whichever it was, both countries were part of the Russian Empire at the time. He came to England in 1904 and in 1906 settled in Glasgow, where he became Secretary of the Amalgamated Jewish Tailors, Machinists and Pressers Trade Union (1913). In 1916 he moved to Leeds, where he held a similar position, and the family remained there until 1934, when he became London organiser of the National Union of Tailors and Garment Workers. He was known for organising the Jewish response to Fascist activities in London's East End (for more information about what was happening please see Battle_of_Cable_Street).

Dr Henry Rollin said that he regarded himself as a Yorkshireman, since his formative years were spent in Leeds. He had wanted to be a writer but his family pushed him into studying medicine at Leeds University. He did not enjoy his medical studies greatly, as there was much learning by rote and he experienced overt anti-Semitism: however, the clinical work did engage his interest and he graduated with a Bachelor of Medicine degree in 1935. In the meantime he had become Leeds and Northern Universities lightweight boxing champion. His first professional post was as a house surgeon at Oldham Royal Infirmary (on pay of 3 a week plus board and lodging, which he later described as 'not a bad salary at that time'). Subsequent posts as a locum, which he mostly hated, convinced him that he had to make a decision on his future direction and to that end, in 1938, he took a job as a ship's surgeon for the Blue Funnel Line, enjoying six months of overseas travel while he considered what to do afterwards.

By now his family was in London, which was where he wanted to be; he obtained a position as Assistant Medical Officer to the London County Council Mental Health Service and was posted to Caterham Hospital (later St Lawrence's), which was essentially an institution for what were then termed 'mental deficients': it was there that he became interested in psychiatry and the thesis for his Doctorate in Medicine was on the subject of Down's Syndrome. During his time at Caterham he studied psychiatry at the Maudsley Hospital in South London and gained a diploma in psychiatric medicine (DPM).

The remains of Caterham/St Lawrence's Hospital
The remains* of Caterham/St Lawrence's Hospital (mainly closed 1994)
Photographed in 2010 by Roger W Haworth. Image source: Wikimedia Commons

*By 2010 most of the hospital had already been redeveloped into housing. The remaining portion was occupied by NHS Direct and also contained a number of small facilities for people with learning disabilities.

The Royal Air Force

Much of the information in this narrative comes from an interview that Dr Rollin gave to Alan Kerr in 1999 (The Psychiatric Bulletin 1999, 23:286-290), in which he comes over as a likeable man of integrity, honesty and humour. When war broke out he was still at Caterham, which suffered from the attentions of the Luftwaffe, being virtually sandwiched between the Guards' Depot and the fighter station at RAF Kenley. Doctors working in and around London were exempted from military service, but by 1941 that situation had changed and Dr Rollin applied for a commission. He chose the RAF because he admired their brave actions during the Battle of Britain, some of which he had witnessed first-hand from the ground.

His first posting was to Training Command at Little Rissington in the Cotswolds, where he mainly acted as a locum medical officer. Late in 1942, however, the Air Ministry realised that he could be better utilised and moved him into neuropsychiatry under the outstanding Air Commodore Richard Dick Gillespie (who sadly died in 1945, aged only 48). Dr Rollin recognised this as the turning point in his career, although his first assignment was not all that glamorous: he was tasked with identifying WAAF recruits who were unlikely to cope with the stress of training.

During his time with the WAAFs Dr Rollin engaged in a study of the relationship, if any, between intelligence and head lice infestation; he gave intelligence tests to two separate groups of women (one group being free of lice and the other being under treatment for infestation) and concluded that the infested group performed less well than the other. It has since been accepted that there is no connection between head lice and intelligence and it has been suggested that Dr Rollin failed to take account of the stress caused by the treatment, which may have impacted on the intelligence test results.

The next posting was to RAF Medical Headquarters in London, where one of his tasks was to differentiate between genuine psychiatric illness and 'lack of moral fibre'. By the end of his time in the RAF he had reached the rank of Wing Commander.

Back to 'Civvy Street'

On leaving the RAF Dr Rollin was still under contract to the LCC, but made it clear that he would rather resign than go back to Caterham Hospital. Consequently, he was sent to Cane Hill Hospital near Coulsdon, where he struck lucky once more, for the man in charge was the eminent Dr Alexander Walk, who was superintendent there for 23 years.

Cane Hill Hospital
Cane Hill Hospital (closed 1991), photographed in 2005 © Hywel Williams
and licensed for reuse under this Creative Commons Licence

It may surprise you to learn at this point that Dr Rollin had not yet completed his Doctorate in Medicine but, encouraged by Dr Walk, he did so in 1947. In 1948 he became Deputy Superintendent of Horton Mental Hospital, where he remained until his retirement in 1975 (some sources say 1976).

Postcard view of Horton Hospital
Postcard view of Horton Hospital, date not known
Image courtesy of Epsom and Ewell Local and Family History Centre

During the war Horton had been occupied by the Emergency Medical Service, so that when Dr Rollin arrived it had to be converted back to a mental hospital and one of the positives of this was that, in the light of advances in treatment/thinking since the place was originally built, the environment could be made more therapeutic than institutional. I will just fast-forward here to a speech made by Enoch Powell in 1961 (we will return to him later) - known as the 'Water Tower' speech - which conjures a graphic vision of Victorian asylums based on appearances and does not dwell on what was actually happening inside them, whether good or bad. Powell said, 'There they stand, isolated, majestic, imperious, brooded over by the gigantic water-tower and chimney combined, rising unmistakable and daunting out of the countryside - the asylums which our forefathers built with such immense solidity to express the notions of their day. Do not for a moment underestimate their powers of resistance to our assault.'

Staff Quarters at Horton Hospital
Staff Quarters at Horton Hospital
Dr Rollin occupied the top floor room with the bay window, and his bedroom was next door.
Image courtesy of Bourne Hall Museum

Dr Rollin saw the conversion of Horton as an opportunity to change the environment and oversaw the establishment of redecorated, open-plan wards; he arranged for the inmates to have better clothes and introduced occupational therapies, music and drama activities, sports, trips and an outpatient clinic. Horton became the leading hospital in the country for music therapy.

Dr Rollin's Horton Hospital staff badge
Dr Rollin's Horton Hospital staff badge
Image courtesy of Bourne Hall Museum

There were of course many types of medical treatment going on at the hospital and you can read more about the mental hospitals in the Epsom Cluster and treatments page. In his interview for The Psychiatric Bulletin Dr Rollin had several specific things to say about various trends in treatment.

Rollin on treatments

Dr Rollin has been described as theoretical and practical and he did not mince his words about some of the ideas which gained ground during his career. In 1953 he was awarded a Fulbright scholarship to study psychoanalysis in the United States and, whilst this trip enhanced his insight into the patient-led model of care, he was not a fan of psychoanalysis, commenting years later that, by virtue of the subsequent trend towards psycho-pharmacology in the US, 'We now had a common language: they called a spade a spade, not a phallic symbol - and we got on fine.'

He admitted in his 1999 interview that he deeply regretted many procedures which were generally accepted practice while he was at Horton and he singled out the prefrontal leucotomy (or lobotomy) as an example.

The lobotomy idea started in about 1930 with experiments on chimpanzees, which very swiftly led to operations on human subjects. There is no disguising the fact that the procedure was experimental in the extreme and carried out with 'instruments' that would have looked more at home in a DIY tool kit. Put very crudely, the thinking behind it was that the frontal lobes of the brain were the seat of mental illness and that a cure could be effected by severing the nerves that connected those lobes with the rest of the brain. There are obviously enormous human rights issues here, but I suppose the first questions must be 'did it work?' and 'was it safe?' The answers are that it was claimed to have worked in some cases, made no difference in some cases, and made the patient worse in many cases. And no, it wasn't particularly safe in several respects.

Set of Watts-Freeman lobotomy instruments; box inscribed by Walter Freeman, circa 1950. WI no. L0026980
Set of Watts-Freeman lobotomy instruments; box inscribed by Walter Freeman, circa 1950.
Image source: Wellcome Images (WI no. L0026980)

The first 20 operations performed in the mid-1930s by Portuguese surgeon Egas Moniz (or rather, by a colleague under his supervision, as Moniz had gout in his hands), who was later awarded the Nobel Prize for his work, involved a range of ages and mental disorders. All 20 patients experienced complications after surgery, such as incontinence and other physical and psychological effects. Until 1942 only six lobotomies had been performed in Britain but it subsequently became a major centre (Sir Wylie McKissock, a leading exponent in Britain, could apparently perform the operation in about five minutes), even though criticism was mounting. Apart from adverse physical effects, many patients showed a marked reduction in initiative and inhibition. An awful example of the possible effects of a lobotomy was President Kennedy's sister Rosemary (born 1918). Rosemary initially had learning disabilities - she was what in those days would have been described as 'backward'. As she grew older she became subject to mood swings and occasional violent outbursts; there seems to be no particular evidence that she had an underlying serious mental illness as we would understand it today, but nevertheless her father received advice that she should undergo a lobotomy. This was 1941 when Rosemary was 23 years old and the procedure was still in its infancy. The operation on Rosemary is described in Wikipedia as follows.
'We went through the top of the head, I think she was awake. She had a mild tranquilizer. I made a surgical incision in the brain through the skull. It was near the front. It was on both sides. We just made a small incision, no more than an inch.'

'The instrument Dr Watts used looked like a butter knife. He swung it up and down to cut brain tissue.'

'As Dr Watts cut, Dr Freeman put questions to Rosemary. For example, he asked her to recite the Lord's Prayer or sing "God Bless America" or count backwards.....'

'We made an estimate on how far to cut based on how she responded.'

'When she began to become incoherent, they stopped.'
Following the operation Rosemary Kennedy's mental capacity declined to that of a two year old; she could not walk or speak intelligibly and was considered incontinent. She was institutionalised for the rest of her life and died in 2005, aged 86. In 1948 eminent American scientist Norbert Wiener said of the lobotomy that 'it has recently been having a certain vogue, probably not unconnected with the fact that it makes the custodial care of many patients easier. Let me remark in passing that killing them makes their custodial care still easier.'

In 1950 the USSR banned the procedure as 'contrary to the principles of humanity' (which speaks volumes, considering that Stalin was still in power at the time).

Dr Rollin was also critical of the first psychoactive drugs, such as chlorpromazine (also known as thorazine or largactil) which had alarming side-effects. However, safer and more effective drugs were developed and chlorpromazine is little used now.

Care in the community

The road to care in the community began in the 1950s, when Commissions looked at the legal balance to be struck between the rights/liberties of mental patients and protection of the public. The outcome was based on two main flawed presumptions, which were that tranquilizers could 'cure' most patients and that the community was more therapeutic than a mental hospital. It was predicted that by 1975 half of the mental hospitals would have disappeared and, indeed, a large number of the old institutions have now gone, as in Epsom and many other places (such as Caterham and Cane Hill, mentioned above). At the time Dr Rollin said that the then current open door policy of mental hospitals would be changed to a revolving door policy and he observed in 1960 that patients were being evicted from hospitals for administrative reasons and not because of any great improvement in their condition. He also said that the community did not care.

Enoch Powell became Minister of Health in 1960 and the following year he delivered the 'Water-Tower' speech. As late as 1993 Powell claimed that his care in the community initiative would have worked properly (i.e. in broad and simple terms, that people with mental difficulties who were suitable to be out in the community would actually receive appropriate care/support and that those who presented a threat to themselves or the public would remain in hospital receiving appropriate treatment), but said that neither the hospitals nor the community facilities had received adequate funding. Dr Rollin said of Powell's plan that improvement and expansion in hospital facilities were needed rather than closure. But the 'initiative' marched on regardless and by the end of the 1960s many beds at Horton had been lost.

Dr Rollin once wrote to the British Medical Journal (concerning another reorganisation of services), saying, 'Doctors and their patients, may I remind them, are not packets of soap-flakes that can be moved from one shelf to the next shelf or from one shop to the next with impunity. Do I sound disenchanted, disillusioned or even a trifle paranoid? I am. I bloody well am.'

'Retirement'

In 1975/6 Dr Rollin retired from Horton. He could have stayed retired and indulged his love of opera, theatre and salt beef sandwiches, but instead he went to work for the Home Office as Consultant Forensic Psychiatrist and tackled his new career with energy and enthusiasm. He served on many mental health tribunals and was a sessional psychiatrist at Brixton prison, where he dealt with mentally abnormal offenders. In 1976 he became a Member of the Royal College of Physicians and was made a Fellow in 1983. He was a leading figure in the effort to raise the Royal Medico-Psychological Association to the status of Royal College and built up that organisation's library; he wrote three books, including a memoir entitled 'Festina Lente' (Hasten Slowly) and contributed about 50 editorials to the British Medical Journal. He was also obituaries editor for the British Journal of Psychiatry until just before his death at the age of 102. He was a long-time resident of Epsom.

Dr Rollin married Anna-Maria Tihanyi in 1973 and at the time of writing Dr Anna-Maria Rollin has been a consultant anaesthetist at Epsom Hospital for 36 years. She is also Professional Standards Advisor to the Royal College of Anaesthetists and was awarded the MBE for services to anaesthesia in the 2014 New Year Honours.


Researched and written by Linda Jackson 2014


Main sources

Obituary, Daily Telegraph of 4 March 2014
The Psychiatric Bulletin 1989, 13: 709-714
The Psychiatric Bulletin 1999, 23: 286-290
Also see www.epsomandewellhistoryexplorer.org.uk/Mott.html


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