The Makers Of Bethlem - Words inspired by Victorian Asylum patients

by David Gilbert

November 13, 2016



“Pills are ok, counselling is ok and it will get you back on the streets, but what keeps your mind alive is what you learn here. That’s what it’s about – keeping your spirit alive.” – Lee, Bethlem artist.


I was recently invited to be part of the Bethlem Gallery’s ‘Reading The Site’ initiative – one part of the stunning ‘Reclaiming The Asylum’ series of events.

My task was to spend a day reading historical material from the Museum of the Mind’s archive – letters from the Victorian Asylum’s patients and clinicians’ notes – and write in response.

The Bethlem Gallery

The Bethlem Gallery is situated on the grounds of The Bethlem Royal Hospital. Managed by a small, artist-led team, the gallery provides a professional space for high-quality artwork and fosters a supportive artist-focused environment. The artists are connected to the hospital, as current or former users or carers.

The gallery is an amazing place and is a platform for experimentation, collaboration and skills exchange. It helps develop the careers, experience and expertise of the gallery artists by creating opportunities for professional development. Its successful artist-in-residence projects also work with patients and staff on site to improve people’s experience of the hospital environment. It sits in the old hospital administration building that has been lovingly restored and also houses the Bethlem Museum of the Mind – a fascinating collection that depicts the history of mental health and care as well as the story of the hospital itself. I recommend a visit. Highly!

Have a look at some of the incredible artists’ works at

I spent a magical day at The Gallery and spent a lot of time chatting to the friendly artists who wandered in and out. One of them took me on a walk round the vast site pointing out the wildlife and regaling me with stories. Others brought me cups of tea and chatted about their art work, lives and mental health experiences. Beth, the curator, told me about what they did, and the relationship between what they do and ‘outsider art’ and ‘art therapy’ (you can read about that on their FAQs on the website).

I felt somehow that I had come home; that this was where I belonged - at the crossroads between mental health, real user engagement, art/poetry (and good coffee and cake).

The archive

The letter below was one of many in the archive from patients or family members. The deference displayed towards the clinician, alongside its surreal narrative and (paradoxically) deep insight into ‘truth’ astounded me. See what you make of it.


Dear Sir

I hope you do not think I went to Bethlem before I should. It was on January the 4th that the egg tasted to me so strange, and on the following Monday morning I began to rub my knee just as I have seen my sister do, the one she had injured, without any will of my own. I knew nothing was the matter with mine. Another morning my mother looked to me quite an ugly old woman for a moment. I shut my eyes for a minute, and when I looked again she looked her old self. I knew at the time she had not changed. With the exception of the egg, which puzzled me, my illness quite differed from how I felt five years ago. Then everything was confusion. This time I used to lie down quietly and have pleasurable sensations, and many things that are difficult to understand seemed quite plain to me then.

I hope you will kindly excuse this note. I feel it to be so very defective.

Believe me, dear Sir, yours very gratefully,

Jessie Mary Cowtan


In response to the letter, the artists I met and the walk around the grounds, this is the poem I wrote. The intention is to connect latter day voices with the voices of present day artists. And to explore whose voice counts (in history, narrative, art). One of the artists I met described himself as a 'maker'. That phrase stuck.

The phrases in italics are taken verbatim from a book - Presumed Curable - that contains clinicians' notes reporting how patients had spoken. Please note that the poem reads better on a PC than a smart phone, as a 'smart' phone is stupid when it comes to line breaks.


The Makers of Bethlem
For Albert, Keith, Matthew and all the makers

If I may Dear Sir

For done wrong,
when the daemons flit
and the quiet unplugs
the underbelly’s rush
I have been too long
at the margins.

From my room – the escape, the bolt-hole, the refuge, the asylum
within a second skin, a filter, a lens, a medium
through which I see you – more clearly than you see fit
or can diagnose – in the seeing of me.

Come closer. These red stripes, diagonally across the paper –
these lines - are the slashes across the past,
my wrists, my neck, my arms.
Feel you safer now to near or care?

Once it was all about morality and sin
I signed my name ‘Petrolium’
then crouched and offered up a litany:
I am the wrong man
My left leg at all times troubles me
The peculiar shock from my head
I have suffered such strong constipation
My food is hard and changes before I swallow
I am upset by the noise of spoons
Or sight of the immoral stethoscope
I am not my mother’s child
I am a great lump of pudding
I speak in rhyme and make of all around me, kings

 I wore strong clothes
And was immersed for days
Gloved now,
I was going to have to finger out my eyeball
I don’t know why I took the parrot out of its cage
And wrung its neck
But tell me why
Any of this is more inexplicable
Than the cause of my being here
When I lie down, there are pleasurable sensations
The smell of egg is strange
I see plain.

Then and now done wrong,
the causes adjust.
We are no more or less lonely
than before, again working with skin and light.

Still, everything is wrong and I am not worth anything.
Life is different from what it used to be. I am ruined
in a thousand translations of when and where
or DSM.

If we are to be found dead
in ye olde brooke or modern reservoir – water is water.
The crow is the modern phoenix – let us pray
to whatever turns us in or on or
makes us out.

Some of us have learned despite,
bring back brick to life.
With leave to walk the springy grass
around the acres by the forensic unit
have begun
picking up bits of wood and taking them back to the room
to paint or work on, then leaving them again in the hedgerows, to see
what happens when they are worn
by the unpredictable elements.

I walk the grounds from six a.m
bring apples to my friends
superior to those you’ll buy in supermarkets.

Did you know that ivy strangles the tree
but when you boil the inch long leaf stem
for as many hours as it takes
for SSRIs to breach the capillaries
the components in the broth
help you breathe more easily?

There are deer and badgers.
The green parakeets continually break
from the woodlands near the bus stop
where the couples quarrel.

Have you listened to that dead tree
bolted and split by the storm’s brash light
harbouring original insect life.
Feel its jutting splintered trunk smoothed
by the wind twisting
around the old administration building.

Can you see it, a totem? Faces gnarled,
gargoyles from the ages
staring from its circumference
out to the fields
or would you have me real?

I am artist. I am maker. I man woman engineer.
I call myself – I call - what I will.

We are the makers,
We are the makers
the muckers, the mucked,
the mocked, the poxed,
the painters, the penned,
the maskers, the markers,
the makers of Bethlem.

I have built a cardboard fire place in my new room,
real with flame.
Come find. Come talk.
Or is it cure you need?
Must we still kneel? Comply?

I work with everything required.
Will you?
And find that tired time has slowed.
Portraits in oils and framed crests
initialled in the old Boardroom
don’t safe speak to me.
I view all things plain.

Your words once cheered,
now I fear I am not so much imposing on your time
as you mine. We
have other paths to run
between and across, beneath and
above, beyond asylum.



If you liked this post, do visit for more musings on healthcare, patient and public engagement, mental health and poetry

If you want to read more poetry about my own mental health experiences, you can do so here and here

(c) David Gilbert and Bethlem Gallery, 2016

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