My interest in John Cade began many, many years ago
when I was a medical student and I
came across a very slim volume called
"Mending the Mind" by John Cade.
Here's a man who introduces the first effective medication
for mental illness, and he's Australian.
I'd never heard of him.
Well, he was a trailblazer in thinking about mental illness.
This was the very first example of something
that could be given to control or cure a mental illness.
John Cade was born in country Victoria in 1912.
His father was a psychiatrist, and the family
spent some of John's early life living and working
on the grounds of Victoria's three main mental hospitals--
Mont Park, Beechworth, and Sunbury.
This experience profoundly affected the way
John thought about mental illness throughout his career
as a psychiatrist.
For him, the sight of a man or woman talking to themselves
wasn't something that was as bizarre as it
was for the average person.
And I think he developed an understanding of their humanity
through that childhood exposure.
And that he really held that all the way
through his professional life.
When the Second World War broke out,
John left his wife, Jean, and his young family
to support the war effort.
He joined the 2nd/9th
Field Ambulance as a surgeon.
The unit was captured in 1942 at the fall of Singapore,
and John saw out the conflict as a prisoner of war and a doctor
at Changi.
When he returned home, he resumed his position
at Bundoora Mental Hospital.
And the family lived in a small cottage
within the hospital grounds.
At the time, Bundoora Mental Hospital had about 200 men.
And they were either diggers from the First World War,
and some from the Second World War.
The number of treatments available at that time
was fairly meagre, which included
electroconvulsive therapy.
So what he does, he looks around this asylum,
and he has this idea that somehow when you're manic
there might be a chemical in the blood
that you've got too much of.
And when we're depressed, we don't have enough of it.
And then he has the moment that changes everything.
Dr. Cade's hypothesis was that the urine from a manic patient
would have different compounds than that of a healthy patient.
Looking for a way to test his theory,
he mixed this uric acid with lithium
so it could be administered to guinea pigs.
As part of his experiments, this lithium,
which he's picked up from these pharmacy stores,
he just decides to inject that into the guinea pigs.
And all of sudden he noticed that the guinea pigs, which
are usually kind of wriggling, rolling, quivering
masses of muscle, just became very quiet.
Almost instantaneously it seems, he
had this idea that if lithium could quell and quieten
a guinea pig, well, why not one of the patients around me?
Dr. Cade tested the drug on himself
over a series of months.
There were no serious side effects,
and he became convinced that lithium could treat mania.
He identified a candidate for treatment, a long-term patient
at Bundoora Mental Hospital.
The first patient was a chap called Bill Brand, known
within the hospital as "the monkey"
because he was a very manic patient.
So he stirred up the solution and gave it to Bill.
Within five or six weeks, this man,
who had run around terrorising patients and staff
in his manic state, he went from that state
to being virtually completely normal.
I don't think John Cade could entirely believe it himself.
It was just a remarkable transformation
because he had been in a manic phase for a number of years,
and he'd had electroconvulsive therapy.
It was an absolutely remarkable turnaround.
There's also the question of, well,
how much lithium do we give?
We're desperately wanting to treat patients,
but are we going to kill them?
Is the risk worth taking?
Dr. Cade began to prescribe lithium
to other patients at Bundoora as Bill Brand continued to improve
and even leave the hospital.
Seemingly cured, Bill stopped taking the medication.
But sadly, his mania returned and he
was readmitted to Bundoora.
Despite ongoing treatment, Bill's health
continued to deteriorate, and eventually Bill died.
Dr. Cade recorded his cause of death
as due to the combined effects of lithium toxicity,
starvation, and chronic mania.
It had a profound effect on John Cade, something which he took,
I think, decades to recover from.
He was very upset because he thought
that this was a wonderfully transforming substance,
and he'd written about it in the Medical Journal of Australia.
And a lot of other psychiatrists had tried it
and had found it to be very effective.
There's no doubt in my mind that John Cade's introduction
of lithium is the single greatest
achievement in the history of Australian mental health.
It was the first specific pharmaceutical-type agent
for a mental illness that has ever been developed.
So from then on a whole series of new
pharmaceutical therapies were introduced.
And this resulted in a change in the way
that institutions functioned for mental illness.
I think his understanding asylum patients and their humanity
growing up with his dad on asylums--
I think his wartime experience was critical.
He knew time was limited and that you
had to make the best of whatever time you had.
I think you see that in a lot of the POWs.
Not just in John Cade, but in many
of those individuals who made their mark in Australian life.