In the October 2013 issue of Medical History, Heidi Knoblauch posed an important question: how should an historian subject a media item to peer-review?Footnote ¹ This replayed over and over in my mind while attempting to review The Madness of Bedlam, and I feel that I have arrived at an important suggestion with regard to documentaries. Reviewers must remove their metaphorical ‘anoraks’ as a matter of urgency. Documentaries are for the consumption of a wide audience, often with no particular interest or previous knowledge of the subject area. Watching a medical history documentary with the express intention of ‘rivet counting’ is therefore not helpful, as the story inevitably has to be edited and simplified in parts. There are of course exceptions to this rule – the re-writing of history with no factual basis for the purpose of entertainment and attempts of presenters to invoke negative opinions or emotions to meet their own ends should be criticised. We must not forget that some members of the public take what they see on television as gospel and I speak with some authority as a teaching assistant and historical interpreter, who has had to sift through the wreckage of BBC’s Blackadder. I therefore believe that documentaries should be reviewed on how they meet their aims, and their educational value in the non-specialist sphere.

In autumn 2013, Channel 4 aired a few programmes that engaged with mental health issues and the history of psychiatry. This run started with a series focusing on patients with psychiatric disorders under the care of the South London and Maudsley NHS Trust, with the not-so-original original title, Bedlam. On the whole, it was done with respect, sympathy and sensitivity. The run culminated in the weird yet slightly wonderful Psychopath Night, which dedicated two hours to ‘exploring the minds’ of psychopaths. This was approached through interviews with diagnosed psychopaths, a ‘Top 10’ list of psychopath films, and associated online content, which encouraged the public to assess their own psychopathic traitsFootnote ². It was a tad too sensationalist for my tastes. Bang in the middle was The Madness of Bedlam: A Time Team Special, which forms the subject of this review. For those not acquainted with British programming, Time Team was a long-running documentary series that followed teams of specialists carrying out archaeological digs across Britain, with actor Tony Robinson explaining the processes in layman’s terms. It ended its twenty-year run in March 2013 but a number of special programmes were commissioned – The Madness of Bedlam representing one of them.

The primary focus of the documentary was to showcase the archaeological dig of the cemetery at the original Bethlem Hospital at the Priory of St Mary of Bethlehem in Bishopsgate. The archaeological teams found hundreds of years’ worth of stacked graves in a number of trenches near Liverpool Street Station, which were uncovered during excavation work for London’s Cross-Rail link. The tone and aims of the documentary were set in the first few spoken statements. Tony Robinson explained that they would be looking for evidence of ‘abuse behind the asylum walls’ and to investigate the ‘so-called cures’ of madness, with the crucial caveat that the archaeologists could not differentiate between the skeletons of Bishopsgate’s dead and those of Bedlam patients. The aim of this documentary was therefore shattered before it had begun. It was immediately apparent that this would be a sensationalist documentary that aimed to inspire revulsion, pity and anger amongst viewers rather than presenting a balanced history of Bedlam. As a medical historian, I did not find this approach very helpful or stimulating but I can understand that these very emotions would keep lay-viewers from changing the channel. The patients of Bedlam were portrayed throughout as people with mental health problems rather than lunatics or the mad. Whether this was done in the spirit of political correctness or to encourage the application of a biased modern mind-set to the problems is unclear. Regardless of the reason, this method effectively demonstrated that attitudes to madness have altered dramatically over the last 600 years.

The story of ‘cruelty, violence, and abuse’ at Bedlam was presented in a simple chronological fashion, starting in the age of the prison-like medieval priory, going on to the therapeutic pessimism of the Monro family, and finishing at the more sympathetic age in Bedlam’s nineteenth-century site in Lambeth. Self-fashioned specialists on the history of Bedlam and known authorities on the history of psychiatry were interviewed, which resulted in an interesting narrative. The popular writers contributed to the ‘abuse’ side of the story, whereas the academic contributors such as Jonathan Andrews, Edgar Jones, and Richard Barnett brought the viewer back down to earth by interpreting primary material, stories, and objects from the various periods. Tales of wronged patients at the hands of the Monros such as James Tilley Matthews and Alexander Cruden provided a much-needed personal dimension to a predominantly institutional history. This documentary would never cover the long history of Bedlam adequately in its time-frame but the major chronological developments were there and the balance between academic and popular opinion was largely effective.

The exploration of the skeletons represented a tiny segment of this 45 min programme. Tony Robinson was in the trench twice and only two skeletons were interpreted by osteo-archaeologists, which were ‘likely patients’ of Bedlam. One skeleton was found to have syphilitic affections of the bones and the other was subjected to a cranial autopsy. This allowed for an explanation of the various stages of syphilis and the shift toward brain localisation. No signs of beatings were identified on these particular skeletons, therefore shattering the dominant abuse narrative. This did not discourage the presenters from continuing in this vein. This element was particularly disappointing, as archaeological interpretation was meant to be at the heart of this documentary. On the other hand, the segments exploring treatments were very entertaining and informative. Co-presenter Alex Langlands tried out some of the treatments available from the medieval to the eighteenth century, including leeches, purgatives, and electro-therapy. Understandably, he passed on the suggestion of a beating. This allowed for short, effective explanations on shifting understandings of psychiatric disorders, including demoniac possession, humoral imbalances, and conditions located in the brain or psyche.

In conclusion, The Madness of Bedlam: A Time Team Special was a very difficult documentary to review. I can imagine that the British public found it very interesting due to its focus on madness and psychiatry, which always attracts high-viewing figures. It was informative in parts and presented the story of Bedlam in a straight-forward fashion. However, the programme largely failed to meet its aims to uncover the history of ‘abuse behind the asylum walls’ by failing to find any evidence of this on the skeletons, which may or may not have been Bedlam patients. As historians, we know that abuse was a part of Bedlam’s history, which was carried out by cruel attendants but this theme was applied to all aspects of asylum life, including treatment. This resulted in a skewed portrayal of the history of the hospital. I firmly believe that the sensationalism of this documentary detracted from its overall educational value and that a more balanced account remains to be presented.