Hearing Voices. Brendan Kelly
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Throughout his career, Norman was an inveterate innovator and a freethinker. In Monaghan, he experimented with hypnone (phenyl-methyl-acetone) and, in a case series published in the Journal of Mental Science in 1887, concluded that it was a useful sleep inducing agent, especially in cases characterised by excitement.230
In 1886, Norman was appointed as RMS in Richmond District Asylum in Dublin, a notably powerful and prominent position in Irish medicine. The energetic, enthusiastic doctor had a profound effect on the vast institution: restraints were relaxed, buildings renovated, staff numbers increased and a laboratory built, placed under the direction of Dr Daniel Rambaut.231
As the Irish Times later noted, Norman’s appointment had immediate positive effects both in the Richmond and beyond:
When he became Superintendent he immediately started a campaign with a view to improving the condition of the patients, and it is mainly owing to his efforts that the dietary and clothing of the inmates have undergone a vast improvement. The reforms he effected in the management of the institution are almost innumerable. To him must also be attributed the initiation of a campaign against the use of instruments of restraint in asylums. On his advice the ‘straight jacket’ was abolished in the institution, and his influence in this respect penetrated into all the asylums in Ireland and very many institutions in England and Scotland. He established the principle of allowing the patients with violent tendencies to walk in the grounds instead of confining them in irons indoors […]. The nursing and attendant staff also engaged his close attention, and he did much in securing for them better accommodation, better clothing, better pay and shorter hours of duty. Dr Norman’s name will be associated with almost all asylum reforms in this country, and it is impossible to estimate his efforts in this respect. His services have brought about a wonderful change in the treatment of lunatics, and many lives have been brightened by his zealous devotion to their welfare.232
While this effusive praise is well deserved and based in fact, Norman was by no means alone in seeking to reduce the use of restraint in the Irish asylums; Dr John Jacob of Maryborough (Portlaoise), for example, was another pioneer in the removal of restraints, in the 1840s.233 Jacob belonged to a distinguished Quaker family and also operated a private asylum in the area. Jacob’s initiative was strongly consistent with the broader ‘non-restraint’ movement in England in the late 1830s,234 as were Norman’s fruitful efforts at the Richmond in the latter part of the century.
Like other reformers, Norman encountered stern opposition to certain of his efforts, including his attempt to develop a model of ‘boarding out’ similar to those in Scotland235 and Belgium.236 The colony at Gheel in Belgium had been founded in the tradition of St Dymphna, an Irish girl who, in the early seventh century, fled there from her father when he sought to marry her in replacement of his deceased wife.237 She went to Gheel with her priest, but her father followed and killed them both. St Dymphna’s remains at Gheel became a focus of pilgrimage for the mentally ill, and Gheel later evolved into a colony for their care.
In 1904, Norman wrote in the Journal of Mental Science about the need for similar ‘family care of persons of unsound mind in Ireland’, noting that there were many objections to be made against asylum life, not least of which was its separation of patients from the ordinary interests of life.238 Norman was deeply opposed to prolonged institutionalisation239 and there was already long standing evidence that care outside of institutions could be effective in Ireland. One such case (and there were likely many) concerned the 16-year-old Charles Stock, son of Bishop Joseph Stock of Killala, who suffered from likely schizophrenia a full century earlier, between 1806 and 1813, but was treated chiefly at home, under the supervision of Dr William Harvey, physician at Steevens Hospital and a governor of the Richmond Asylum.240 Notwithstanding such cases and the many clear objections to asylum life, Norman’s enlightened suggestions about ‘boarding out’ and ‘family care’ did not find favour with governmental authorities and so did not prosper at that time.
Notwithstanding these setbacks, Norman remained extremely active, enthusiastic and highly productive both in his clinical work and in the broader context of the emerging profession of psychiatry. He was deeply involved with the MPA, becoming a member in 1880, secretary to the Irish division in 1887 (until 1904), and president in 1894. In his presidential address, Norman touched on many of the themes that defined his career and contribution to psychiatry: education in asylums, research in pathology and physiology, asylum management and models of family care.241
More broadly, Norman’s vivid, incisive and plentiful writings covered such themes as aphasia, brain tumours, dementia, medication trials, hallucinations, delusional insanity, beri beri (based on his controversial experiences at the Richmond from 1894 onward),242 diagnostic systems243 and dysentery.244 Norman spoke out strongly about mental health law (bemoaning disproportionate force and incarceration)245 and made robust contributions to Allbutt’s System of Medicine246 and Tuke’s Dictionary of Psychological Medicine.247 In his personal life, Norman maintained strong interests in book collecting, literature, botany, archaeology, architecture, music and languages, and was a keen student of German, French and Italian. His library, presented to the Royal College of Physicians of Ireland following his death, reveals the depth and breadth of his reading across classic and lesser known texts in English, French and German.248
In addition to his participation in the MPA, Norman was a member of the British Medical Association, joint editor of the MPA’s Journal of Mental Science,249 and vice president of the Royal College of Physicians of Ireland,250 among other positions.251 In 1907, he received a richly merited honorary doctorate (MD) from Trinity College, Dublin.
The following year, however, Norman died unexpectedly just outside his home on the North Circular Road, as reported in the Irish Times:
With deep regret we announce the death of Dr Conolly Norman, Resident Medical Superintendent, Richmond Lunatic Asylum, Dublin, which occurred with painful suddenness on Sunday afternoon. About four o’clock in the afternoon Dr Norman left his residence, St Dympna’s, North Circular Road, Dublin for a short walk, but after going a few hundred yards he became ill, and collapsed on the pavement. Mr Neill, Head Attendant at the Asylum, who lived near, was informed, and had Dr Norman conveyed to his home. Sir Thornley Stoker, Dr Finny, and Dr Cullinan were quickly in attendance, but Dr Norman had already died. For some months past he was unwell, suffering from a severe attack of influenza, followed by bronchitis, and moreover, he suffered from a cardiac affection.252 In December last he was obliged to relinquish his duties with a view to recuperating his health. Last week he resumed duty and appeared to have greatly benefited by his rest.253
The Irish Times noted that Norman’s sudden death on 23 February 1908 would ‘be received with sincere regret by every section of the community. His loss is a public one for Dr Norman devoted his life to the care of afflicted humanity, and how nobly he fulfilled his trust is recognised on all sides’.254 Norman was buried in Mount Jerome Cemetery on 26 February 1908255 and fulsome tributes were paid at a special meeting of the Joint Committee of the Richmond District Asylum the following day.256
Norman was a well-known figure, widely respected and duly mentioned in the opening pages of Joyce’s Ulysses.257 A memorial by Joseph M.S. Carré was erected by public subscription in St Patrick’s Cathedral, Dublin and unveiled on 18 October 1910 by the Lord Lieutenant, the Earl of Aberdeen, who spoke highly of Norman’s life and work.258 An after-care programme was established in Norman’s honour and a portrait presented to the Royal College of Physicians, of which he had been vice president.259 The Conolly Norman medal was also initiated, to be presented to the best student in psychiatry at Trinity College Dublin annually.
As the British Medical Journal noted, Norman’s career combined intellectual brilliance with pragmatic devotion